Core Competencies for State Flex Program Excellence Guide

This guide offers anyone who manages and/or works with the Flex Program the opportunity to complete a competency self-assessment, identify areas of proficiency, recognize opportunities for improvement and development, and gather insight into what determines proficiency. Tips, tools, and resources are also included in the guide to provide additional background and support.

This guide lays out the 10 core competencies of an effective and impactful Flex Program, including:

• Developing Leadership and Workforce
• Managing the Flex Program
• Planning Strategically
• Managing Information and Evaluation
• Building and Sustaining Partnerships
• Understanding Policies and Regulations
• Strengthening Quality Reporting and Improvement
• Improving Financial Sustainability
• Understanding the Current and Future Health Care Environment
• Addressing Community Needs

Updated April 2026