Director, Medicaid Healthcare Services Solutions
Location
United States
Posted
12 days ago
Salary
Not specified
No structured requirement data.
Job Description
Role Description
This position is Flexible and the individual may reside in any KP authorized state including California, Oregon, Colorado, Washington, Hawaii, Georgia, Maryland and Washington DC.
Director of Medicaid Health Care Services Solutions plays a critical role in the Medicaid Line of Business to ensure all Medicaid programs meet state regulatory requirements and align with National Medicaid Care Model. This position reports to the Sr. Director of Medicaid Solutions and focuses on developing and managing the execution of the solution roadmap for Health Care Services related solutions in partnership with our IT, informatics and data analytic partners.
- Solutions focus on functional areas such as Care Coordination / Care Management, Utilization Management, Population Health Management, and Quality.
- Interface with Market operational and Permanente Medicaid Group partners to focus on Medicaid specific benefits and programs.
- Maximize regulatory compliance while improving member care experience and operational performance.
- Oversee and direct a team of consultants to ensure alignment, buy-in, and coordination of diverse stakeholders.
- Drive the development and implementation of complex clinical initiatives, systems, and processes.
- Ensure organizational alignment and prioritization of clinical initiatives by developing and determining goals and priorities.
- Oversee the management of complex, highly visible projects or project components.
- Monitor and take accountability for compliance of team work activities.
Qualifications
- Bachelor's degree in Nursing, Health Care, Public Administration, Public Health, Statistics, Science or a directly related field.
- Minimum ten (10) years progressive experience in consulting, data analytics, or project management in clinical operations or a health care environment OR
- Master's degree in Nursing, Health Care, Public Administration, Public Health or a directly related field and minimum eight (8) years progressive experience in consulting, data analytics, or project management in clinical operations or a health care environment, or a directly related field OR
- Minimum thirteen (13) years progressive experience in consulting, data analytics, or project management in clinical operations or a health care environment, or a directly related field.
- Minimum three (3) years supervisory experience with direct reports.
Requirements
- Solicits and acts on performance feedback; drives collaboration to set goals and provide open feedback and coaching.
- Stays up to date with organizational best practices, processes, benchmarks, and industry trends.
- Motivates and empowers teams; maintains a highly skilled and engaged workforce.
- Communicates goals and objectives; analyzes resources, costs, and forecasts and incorporates them into business plans.
- Removes obstacles that impact performance; guides performance and develops contingency plans accordingly.
- Oversees the operation of multiple units within a department by identifying member and operational needs.
- Gains cross-functional support for business plans and priorities; assumes responsibility for decision making.
- Oversees and directs a team of consultants in the development of requirements for complex clinical, process, or system solutions.
- Drives the development of clinical or care delivery strategy and ensures organizational alignment.
- Serves as a lead advocate of continuous learning and professional development.
- Oversees large and complex change management activities associated with care delivery or clinical initiatives.
- Directs team members in performing complex data analyses to drive care delivery or clinical initiatives.
- Oversees vendor management as required.
Company Description
Job Requirements
- Bachelor's degree in Nursing, Health Care, Public Administration, Public Health, Statistics, Science or a directly related field.
- Minimum ten (10) years progressive experience in consulting, data analytics, or project management in clinical operations or a health care environment OR
- Master's degree in Nursing, Health Care, Public Administration, Public Health or a directly related field and minimum eight (8) years progressive experience in consulting, data analytics, or project management in clinical operations or a health care environment, or a directly related field OR
- Minimum thirteen (13) years progressive experience in consulting, data analytics, or project management in clinical operations or a health care environment, or a directly related field.
- Minimum three (3) years supervisory experience with direct reports.
- Solicits and acts on performance feedback; drives collaboration to set goals and provide open feedback and coaching.
- Stays up to date with organizational best practices, processes, benchmarks, and industry trends.
- Motivates and empowers teams; maintains a highly skilled and engaged workforce.
- Communicates goals and objectives; analyzes resources, costs, and forecasts and incorporates them into business plans.
- Removes obstacles that impact performance; guides performance and develops contingency plans accordingly.
- Oversees the operation of multiple units within a department by identifying member and operational needs.
- Gains cross-functional support for business plans and priorities; assumes responsibility for decision making.
- Oversees and directs a team of consultants in the development of requirements for complex clinical, process, or system solutions.
- Drives the development of clinical or care delivery strategy and ensures organizational alignment.
- Serves as a lead advocate of continuous learning and professional development.
- Oversees large and complex change management activities associated with care delivery or clinical initiatives.
- Directs team members in performing complex data analyses to drive care delivery or clinical initiatives.
- Oversees vendor management as required.
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