John Giles

by Jasmine Phiri

August 11, 2021

Director, Managed Care Policy,
Centers for Medicare & Medicaid Services (CMS)

John Giles is the Director for the Division of Managed Care Policy within the Center for Medicaid and CHIP Services (CMCS) at the Centers for Medicare & Medicaid Services (CMS). In this role, he manages the Medicaid managed care policy activities across four primary portfolios of work, including Medicaid managed care policy development, delivery system and provider payment initiatives, capitation rate development, and Medicaid managed care medical loss ratios (MLRs). John initially joined CMS in 2014 and has been a principal author for several recent Medicaid managed care regulations, including the 2016, 2017, and 2020 Medicaid managed care final rules. Prior to his work at CMS, John served in a mix of roles for the State of Oklahoma, including the Director of the Center for Health Innovation and Effectiveness for the Oklahoma State Department of Health and Senior Policy Specialist for the Oklahoma Health Care Authority.