JOB SUMMARY

　　The Manager of Medicaid Performance is responsible for professional and technical planning, design, and coordination of projects and initiatives for Health Plan Medicaid Programs. Works closely with management teams across multiple departments and contracted vendors to ensure that projects and initiatives are implemented timely, accurately, and completely. Responsible for day-to-day management and oversight of one or more Medicaid-contracted vendors.

　　ESSENTIAL FUNCTIONS OF THE ROLE

　　Provides program/project leadership and management through the design, planning, and coordination of project implementations.

　　With direction from leadership, examines Medicaid program performance to calculate opportunities for improvement, identifying performance gaps, prioritizing opportunities, and implementing improvements that align with organizational goals and result in sustainable gains and outcomes.

　　Organizes and runs assigned projects and initiatives using methods of team building, data gathering and testing, process mapping, and problem solving.

　　Builds and develops working relationships through coaching/mentoring of project team members and business partners to foster a culture of continuous improvement.

　　Participates in developing and delivering training content in support of improvement strategies.

　　Establishes appropriate tools to monitor progress of planned improvement implementations and achievement of expected benefits.

　　Engages department heads and develops reporting to track performance across the Plan and provides leadership visibility of key metrics.

　　Collaborates with department and plan leadership to develop reporting to track Medicaid performance; conducts monthly meeting to review performance metrics with managers.

　　Develops a collaborative relationship with other regulatory related resources across the company, including the Compliance department.

　　Resolves common and complex business issues within established guidelines and recommends appropriate alternatives.

　　Provides direction to Plan departments and facilitates information validation and choice-making; handles most unique situations.

　　KEY SUCCESS FACTORS

　　Proven working knowledge of laws governing the provision of government subsidized health coverage, including Medicaid and Childrens Health Insurance Programs.

　　Organization and leadership skills; able to influence others.

　　Self-supporting thinker with excellent judgment and ability to work in a dynamic environment.

　　Diagnostic ability for assessing and resolving business needs via innovative concepts.

　　Data-based ability to understand complex business rules and apply knowledge to develop and create solutions.

　　Excellent communicator, excellent oral and written presentation skills.

　　Advanced proficiency in Word, Excel and PowerPoint. Graphic skills helpful.

　　Consistently demonstrates the ability to recognize, establish and deal with priorities promptly.

　　Maintains favorable working relationships between outside vendors and the Health Plan.

　　Demonstrated commitment to serving a diverse population to assist them in meeting their health and social needs.

　　Able to work in a fast-paced environment with clear focus on program priorities and able to balance the social, cultural and financial challenges of this program.

　　Five years project management of healthcare projects required.

　　BENEFITS - Our competitive benefits package includes the following

　　Immediate eligibility for health and welfare benefits

　　401(k) savings plan with dollar-for-dollar match up to 5%

　　Tuition Reimbursement

　　PTO accrual beginning Day 1

　　Note: Benefits may vary based upon position type and/or level

　　QUALIFICATIONS

　　EDUCATION - Bachelor's Degree or HS Diploma/GED plus 9 years of work experience

　　EXPERIENCE - 5 years of experience

　　As a health care system committed to improving the health of those we serve, we are asking our employees to model the same behaviours that we promote to our patients. As of January 1, 2012, Baylor Scott & White Health no longer hires individuals who use nicotine products. We are an equal opportunity employer committed to ensuring a diverse workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.