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　　Medicaid State operations Director

　　Job Family: Business Support

　　Type: Full time

　　Date Posted:Jan 23, 2024

　　Anticipated End Date:Feb 23, 2024

　　Reference: JR102442

　　Location:

　　DC, WASHINGTONDescription

　　Location: District of Columbia

　　Hours: M – F Standard Working Hours

　　Travel: Hybrid (1-2 days in office per week)

　　Position Overview:

　　Responsible operations functions, including coordination between internal departments, ensuring the appropriate strategy, tactics and processes are in place to affect solid organizational operations and oversight. This role will also oversee the day-to-day management of all operations; and ensures that performance measures from the District and CMS requirements are met.

　　How You Will Make an Impact:

　　Establishes state/regional strategic plans and objectives to meet business unit goals.

　　Assumes leadership role in implementing corporate initiatives, including special project planning and budget management.

　　Plans, directs, and secures the resources (people, material, data and support) for staff to effectively accomplish operational needs and strategic initiatives.

　　Motivates associates to accomplish goals and objectives.

　　Champions initiatives by developing and managing State rate negotiations and key relationships with government, regulatory, Medicaid/SCHIP and other stakeholders as appropriate.

　　Provides coordinated analysis and regional solutions to issues.

　　Guides implementation of programs and strategies.

　　Collaborates with senior management to develop and implement new programs to enhance relationships with key stakeholders and to promote programs and services.

　　Collaborates with Marketing Management to develop marketing strategies for member recruitment and retention for all assigned lines of business.

　　Directs strategic planning on marketing, network maintenance and development and program advocacy in assigned area.

　　Resolves programmatic challenges related to program operations including member issues, provider claims and provider network.

　　Manages projects and issues across departmental and divisional lines to facilitate timely resolution. Represents business unit on national/state/regional boards, task forces, and work groups that impact the health care delivery system and other key health care issues.

　　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

　　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

　　Serves as a liaison with state regulatory agencies 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:

　　Proven experience working in a Matrix Healthcare Environment Strongly preferred

　　Degrees in MBA, MHA, MPH strongly preferred

　　Bid Data/Analysis experience is a must

　　Proactive mindset strongly preferred

　　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. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

　　We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

　　Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

　　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 will also follow all relevant federal, state and local laws.

　　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. Applicants who require accommodation to participate in the job application process may contact [email protected] for assistance.

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　　Elevance Health, Inc. is anE-verify Employer (https://www.e-verify.gov/sites/default/files/everify/posters/EVerifyParticipationPoster.pdf)

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