Anticipated End Date: 2024-10-20
Position Title: Medicaid State Ops Director
Job Description:
LOCATION: This position will work a hybrid model and you must reside within 50 miles of our Las Vegas office. You are expected to be in this office 3x per week.
HOURS: General business hours, Monday through Friday.
TRAVEL: Some travel may be required.
The Medicaid State Ops Director is an individual contributor role responsible for fiscal and operational management of state regional Health Plans, including coordination between internal departments, ensuring the appropriate strategy, tactics, and processes are in place to affect solid organizational operations and oversight.
Primary duties may include, but are not limited to:
- Resolves programmatic challenges related to operations including member issues, provider claims issues, contract configuration issues, etc.
- Serves as liaison to Health Plan support services, which could include: Claims, Enrollment, NCC, PDM/PDQ, configuration; Quality, Regulatory Compliance, IT, Reimbursement policy, etc.
- Leads program development to ensure members, network providers, and community partners successfully participate.
- Identifies opportunities for Operational Excellence and works to create seamless processes between shared services and the Health Plan.
- Develops and implements key operational indicators to be used for monitoring and analysis of the Health Plan operations.
- Along with State CEO and COO, establishes overall standards, policies, and objectives for Health Plan in accordance with applicable regulatory agencies, and serves as a liaison when appropriate.
Required Qualifications:
- Requires a BA/BS in Business, Healthcare Administration or related field and minimum of 10 years experience, including minimum of 8 years in-depth experience in managed care operations; or any combination of education and experience, which would provide an equivalent background.
Preferred Qualifications:
- Previous experience developing and overseeing Medicaid State programs is very strongly preferred.
- Masters degree preferred.
- Six Sigma Black Belt preferred.
For candidates working in person or remotely in the below location(s), the salary range for this specific position is $128,772 - $193,158.
Location(s): Nevada
In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution (all benefits are subject to eligibility requirements).
Job Level: Director Equivalent
Workshift: 1st Shift (United States of America)
Job Family: BSP > Operations
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are: Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work: At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation.
Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.
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