Sen. Max Baucus (D-Mont.) takes his job interviews very seriously, Liz Fowler learned.

In 2000, Fowler was eyeing an appealing opening on Baucus’s Finance Committee staff. She didn’t realize that the panel’s ranking member would put her through her paces before her first day as chief health and entitlements counsel.

“It was a very intense interview process,” says Fowler, who this year became vice president for public policy and external affairs at the health-insurance giant Wellpoint.

Fowler boasts impressive academic credentials: a law degree from the University of Minnesota, a Ph.D. from Johns Hopkins University and an undergraduate degree from the University of Pennsylvania.

The Wichita, Kan., native had just split a year working for then-Sen. Daniel Patrick Moynihan (D-N.Y.) on the Finance Committee and for Rep. Pete Stark (D-Calif.) on the Joint Economic Committee. Before that, she had served stints at Hogan & Hartson, the Medicare and Medicaid agency and a private healthcare research foundation.

But Baucus, the senior Democrat on the panel, wanted further proof before Fowler started her four-year tenure on his staff.

“I had to write two memos, interview with his staff, his former staff and Bentsen’s former chief health counsel,” she says, referring to former Finance Committee Chairman Lloyd Bentsen (D-Texas), “and with the senator.”

All of this took a few months, Fowler recounts. “It was a lengthy interview process ’cause he just wasn’t quite sure.”

Baucus questioned her aggressiveness, Fowler recalls. “Are you assertive enough? Do you have the personality to stand up for yourself?” she remembers him asking.

According to two Republican staffers who worked with her, and sometimes faced off against her, Baucus had no reason to worry.

She was “tenacious,” Mark Hayes and Dean Rosen both recall.

“She represented Sen. Baucus extremely well,” says Hayes, the top healthcare aide to Sen. Chuck Grassley (R-Iowa), chairman and soon-to-be ranking Republican on the Finance Committee. Rosen is a former senior healthcare adviser to Sen. Bill Frist (R-Tenn.) who now heads the healthcare practice at Mehlman Vogel Castagnetti.

Baucus has no regrets about hiring Fowler.

“Liz is one of the smartest, most effective, most conscientious persons I’ve ever met,” he wrote in an e-mail to The Hill. He also emphasized her demeanor. “Always smiling, always upbeat, always positive, looking for good public policy solutions,” he wrote.

For her part, Fowler says, “I don’t know that I’ll ever have a job that I love that much.”

She says that she might have gotten off easy compared to some staffers. During her years on the Finance Committee, Congress was moving legislation to increase payments to healthcare providers that had been cut before she came to Congress. “When I was on the Hill, people liked me because I was working on bills that gave away money,” she says. “I always joke that the reason that I have a lot of friends is ’cause I got to give away money.”

But the signature legislative accomplishment, and personal experience, of her time with the Finance Committee was the Medicare Part D prescription-drug benefit. Fowler was at the center of negotiations that led to the 2003 enactment of the Medicare Modernization Act.

Grassley and Baucus and their aides worked closely together on the Medicare drug bill that they moved through their committee.

Hayes has a memento from that period, a sheet of paper on which Fowler wrote out the framework for the compromise between Grassley’s and Baucus’s staffs before they brought a bill to the committee.

“That was S. 1,” Hayes says, referring to the designation for the Senate-passed Medicare bill. “That’s where the Medicare Modernization Act was born.”

On the House side, however, Ways and Means Committee Chairman Bill Thomas (R-Calif.) and then-Energy and Commerce Committee Chairman Billy Tauzin (R-La.) forged ahead without their Democratic colleagues, setting up a clash that would have ramifications for Baucus’s staff.

When the time came for conference negotiations, Baucus and then-Sen. John Breaux (D-La.) were confronted with a choice: try to influence the Republicans who shut out the rest of the Democrats and give them and the president a major legislative victory, or reject the process and hope the GOP couldn’t assemble a coalition to move its legislation.

Baucus and Breaux chose the former, which placed their aides in the awkward position of trying to represent Democratic principles in a mostly Republican setting while being criticized by their Democratic colleagues for being there at all.

“When Sen. Baucus would go back to report to the Democrats, they really felt like we’re giving up too much and the bill was moving too far to the right,” she remembers. Meanwhile, in Thomas’s Capitol hideaway where the conference talks took place, “Some members on the Republican side really felt like [Baucus] was winning on too many issues.”

Fowler “really felt caught in the middle.” Among her and other Democrats on the Hill, the debate over the MMA was trying. “It was a real test of trust and a test of friendship,” she says.

“In some ways, it was policymaking at its best, really ironing out these differences” with the Republicans. “But in some ways it was policymaking at its worst, given that a lot of our colleagues weren’t at the table like they were supposed to be.

“It was a very stressful, very stressful, period in my life, but at the same time it was one of the most rewarding things that I’ve worked on.”

But when it was all over, Fowler needed a change of pace and focus. “Personally and professionally, it was challenging,” she says. “I wasn’t able to spend a lot of time doing anything but work, really.”

Fowler did not consider leaving the Finance Committee lightly. “Part of the problem with leaving the Hill is that that was my dream job. Now, where do you go after you’ve fulfilled that dream?”

Around the time in 2005 when Fowler began to think about this, the consulting group Health Policy Alternatives approached her.

Mike Hash, a principal at the company, said Fowler was one of its primary targets when a retirement created a vacancy in the shop. He and his colleagues were pleasantly surprised that she would consider joining them.

“She’s an extraordinarily talented and capable person,” says Hash, who during the Clinton administration was deputy administrator of the Health Care Financing Administration (HCFA), the predecessor agency to the Centers for Medicare and Medicaid Services (CMS).

Fowler says she found what she needed at Health Policy Alternatives: a more regular workday and a chance to return to the policy issues she pursued in academic settings.

“What I really wanted when I left the Hill was, in addition to a slower pace — because I was really burned out from MMA — to get back into the details. It just seemed like on the Hill, you’re a mile wide and an inch deep.”

After about a year at the consulting job, Fowler moved to Wellpoint, which at 34 million members bills itself as the largest health-benefits company in the country.

She talks about her new responsibilities as an extension of her academic career,  her experience on the Hill and her work with HCFA. Fowler notes that she had never worked for a private health-insurance company despite her experience helping to make and carry out federal policy affecting the sector.

For now, she says she is spending a lot of her time helping Wellpoint develop a policy agenda on all the health issues facing the company. The firm is the product of a 2004 merger between Wellpoint and Anthem, and their positions have to be reconciled.

Fowler said that the Democratic takeover of Congress is a mixed bag for Wellpoint.

“In some respects, it doesn’t matter because this is a company and it’s got a business to run” regardless of who is in power. “On the other hand, I’d say in some ways it’ll be a more challenging environment, but in some ways there are a lot more opportunities,” specifically related to the private sector’s role in any initiatives to reduce the number of people without health coverage.

Although Fowler did not want to speculate too much about what her professional future might hold, she did say there are things she misses about public life. “Eventually, I’d like to go back to government. I don’t know what that position might be.

“I’ve never run an agency,” she quipped.

Whether the next president is a Democrat could be an important factor. “There’s probably 250 Democrats just in Washington who are waiting to see what happens in 2008,” she said.