Mandy Cohen: A Career in Public Health Leadership
From grassroots advocacy to leading the nation's premier health agency, Mandy Cohen has established herself as a pivotal figure in American public health. With a career spanning federal administration, state-level crisis management, and private sector innovation, Cohen has consistently focused on expanding healthcare access and improving systemic health outcomes.
Key Facts
- Current Role: Director of the U.S. Centers for Disease Control and Prevention (CDC) and Administrator of the Agency for Toxic Substances and Disease Registry.
- State Leadership: Former Secretary of the North Carolina Department of Health and Human Services (NCDHHS) from 2017 to 2022.
- Federal Experience: Former senior advisor and acting director within the Centers for Medicare & Medicaid Services (CMS).
- Major Achievements: Led North Carolina's first decline in overdose deaths in over a decade and managed the state's COVID-19 response.
- Recognition: Named to the 2024 Time 100 Health list of most influential people.
Early Career and Federal Foundations
After completing her residency in Boston, Cohen transitioned to Washington, D.C., where she began her tenure in public service. Between 2008 and 2009, she served as the Deputy Director of Comprehensive Women's Health Services for the U.S. Department of Veterans Affairs. During this period, she also co-founded Doctors for Obama (later renamed Doctors for America), serving as its National Outreach Director, policy director, and eventually Executive Director.
In 2013, Cohen joined the Centers for Medicare & Medicaid Services (CMS)—a federal agency under the Department of Health and Human Services—as a senior advisor. Her work focused on implementing policies for Medicare, Medicaid, and the Children's Health Insurance Program, as well as the Federally Facilitated Marketplace established by the Patient Protection and Affordable Care Act (ACA). She eventually rose to the position of chief operating officer and chief of staff services, and from 2014 to 2015, she served as the acting director of the Center for Consumer Information and Insurance Oversight.
While eight months pregnant in 2014, Cohen appeared before the U.S. Congress to advocate for the inclusion of maternity coverage within the Affordable Care Act.
Leading North Carolina's Health Infrastructure
In January 2017, Governor Roy Cooper appointed Cohen as the Secretary of the North Carolina Department of Health and Human Services (NCDHHS). In this role, she managed a $20 billion annual budget and a workforce of 17,000 employees. Her tenure was marked by the management of several critical health crises, including the opioid epidemic and the presence of GenX chemicals in drinking water.
Medicaid Innovation and Public Health Initiatives
Cohen navigated a complex political landscape regarding Medicaid expansion. She helped transition the state from a fee-for-service model to a contracted model with private insurance companies. One of her most significant initiatives was Healthy Opportunities, a $650 million program authorized by CMS. This initiative tested whether providing high-need Medicaid enrollees with social supports—such as housing, food, transportation, and interpersonal safety—could improve overall public health and lower costs.
Combating the Opioid Crisis and Supporting Children
To address substance abuse, Cohen implemented the Opioid Action Plan. Utilizing $45.5 million in grant funding, the plan updated the Controlled Substance Reporting System to help physicians identify high-risk patients. These efforts contributed to the first decline in North Carolina's overdose deaths in more than ten years. Additionally, she led the Early Childhood Action Plan to improve health outcomes for children from birth to age eight.
Despite her successes, Cohen was a vocal critic of budget cuts. In 2019, she argued that proposed cuts to the NCDHHS could jeopardize essential services, ranging from restaurant health inspections to child protective services and drinking water safety.
Managing the COVID-19 Pandemic
During the COVID-19 pandemic, Cohen became the public face of North Carolina's health response. She advocated for social distancing, hand washing, and the use of face masks. Her leadership involved coordinating with federal officials, including U.S. Health and Human Services Secretary Alex Azar, to secure necessary chemical reagents for testing.
Cohen's strategic response included the creation of up to 300 testing sites and a partnership with Omnicare (a CVS Health company) to test 36,000 nursing home residents and 25,000 employees across 400 locations. While she expressed concerns regarding teacher safety during school reopenings, she noted that studies indicated the virus had minimal health consequences for younger children and that schools were not primary drivers of the spread.
As cases rose, Cohen linked the increase to the state's reopening and identified specific counties for testing surges, including Wake, Mecklenburg, Durham, and Forsyth.
Transition to the Private Sector and the CDC
Cohen left her post as health secretary on January 1, 2022. She briefly entered the private sector as the CEO of Aledade Care Solutions, a primary care enablement company. Throughout her various roles, she has also maintained an academic presence as an adjunct professor of health policy and management at the University of North Carolina at Chapel Hill's Gillings School of Global Public Health.
In June 2023, President Joe Biden appointed Cohen as the Director of the U.S. Centers for Disease Control and Prevention (CDC), succeeding Rochelle Walensky. She was sworn in on July 10, 2023, and also serves as the Administrator of the Agency for Toxic Substances and Disease Registry.
Career Summary
| Period | Organization | Key Role/Achievement |
|---|---|---|
| 2008–2009 | U.S. Dept. of Veterans Affairs | Deputy Director, Comprehensive Women's Health Services |
| 2013–2015 | CMS | Senior Advisor; Acting Director, Center for Consumer Information |
| 2017–2022 | NCDHHS | Secretary; Led COVID-19 and Opioid Action Plan responses |
| 2022–2023 | Aledade Care Solutions | Chief Executive Officer |
| 2023–Present | CDC | Director and Administrator of ATSDR |
Frequently Asked Questions
What is Mandy Cohen's current role?
Mandy Cohen is currently the Director of the U.S. Centers for Disease Control and Prevention (CDC) and the Administrator of the Agency for Toxic Substances and Disease Registry.
What was the goal of the Healthy Opportunities initiative?
The Healthy Opportunities initiative aimed to improve public health and reduce costs by providing high-need Medicaid enrollees with essential social interventions, including housing, food, transportation, and interpersonal safety.
How did Cohen address the opioid epidemic in North Carolina?
She implemented the Opioid Action Plan using $45.5 million in grants and updated the Controlled Substance Reporting System, which helped lead to the first decline in overdose deaths in the state in over a decade.
What was Cohen's approach to COVID-19 testing in nursing homes?
Cohen partnered with Omnicare, a CVS Health company, to administer tests to 36,000 residents and 25,000 employees across more than 400 nursing home locations.
Which academic institution is Cohen affiliated with?
Cohen is an adjunct professor of health policy and management at the University of North Carolina at Chapel Hill's Gillings School of Global Public Health.