By Katherine Gregg
Journal State House Bureau

PROVIDENCE, R.I. -- With the state embarked on a major Medicaid overhaul aimed at saving tens of millions of dollars over the next five years, the Carcieri administration is about to fill a critical job empty since late-September 2008: state Medicaid director.
Elena Nicolella starts on Monday as the state's new $87,139 a year associate director, Department of Human Services, Division of Medical Services. The job has been vacant since Frank Spinelli's retirement a year ago.

Nicolella of Lincoln has been on the state payroll since November 2006 in a different capacity, as a consultant to the state Department of Mental Health, Retardation and Hospitals and then to DHS during the Carcieri administration's pursuit of a first-of-its-kind federal waiver capping state Medicaid spending in exchange for unprecedented freedom in how the dollars are spent on health care for the poor, the elderly and the disabled.

She helped develop the waiver request to the federal government, participated in negotiations and public briefings, and subsequently took on some of the responsibility for coordinating the implementation of this money-saving experiment aimed, in part, at diverting people from nursing homes into cheaper settings that are still in the planning stages.

Prior to that, she worked in Boston for the Centers for Medicare & Medicaid Services as a health insurance specialist (1998-2006), and the U.S. Department of Agriculture's Food and Nutrition Service (1993-98). She is a 1991 graduate of New York University with a degree in French Literature, and the Boston University School of Public Health, with a 1998 master's degree in public health.