Gary is the recent former Deputy Executive Commissioner for Medical and Social Services in Texas, the largest division in the Health and Human Services System. As Deputy Executive Commissioner, Gary oversaw four departments composed of over 13,000 staff and an operating budget of over $50 billion, bringing together client services, including eligibility services, Medicaid/CHIP services and functions (FFS and managed care), and community programs under one coordinated division.

Prior to this, Gary served as the State Medicaid Director, where he was responsible for overseeing services and supports for more than four million Texans across the state. He also previously served as the Chief Deputy Director for Program Operations in the Medicaid/CHIP Division. Before joining the Texas Health and Human Services Commission, Gary served as the Assistant Commissioner for the Access and Intake Division at the Texas Department of Aging and Disability Services.