Dir II Medicaid State Ops

Location: This position will work a hybrid model and must reside within 50 miles of our Metairie, LA location at 3850 N CAUSEWAY BLVD.

Responsible for fiscal and operational management of state regional Health Plans.

Primary duties may include, but are not limited to:

• Develops, directs, plans, and evaluates the goals and objectives of regional area within a State Health Plan.

• Along with State CEO and COO, establishes overall standards, policies and objectives for Health Plan in accordance with applicable regulatory requirements; ensures alignment and support with overall Medicaid Business Unit mission, goals and objectives.

• Responsible for local marketing and community relations, network development, provider partnerships, provider relations, medical management, case management and quality management programs, performance management/improvement, budgets, complaints and appeals, regulatory and contractual compliance, monthly financials, and reporting.

• Resolves complex financial, legal, or politically sensitive issues.

• Leads program development to ensure members, network providers, and community partners successfully participate.

• Leads and manages the local Health Plan performance management/operating gain improvement activities.

• Develops short and long term marketing and retention strategies and objectives. Hires, trains, coaches, counsels, and evaluates performance of direct reports.

Minimum Qualifications

• Requires a BA/BS in a related field and minimum of 8 years relevant experience, including in-depth experience in the HMO/healthcare field, minimum of 5 years working with Medicaid and/or Medicare programs; or any combination of education and experience, which would provide an equivalent background.

Preferred skills, qualifications and experiences:

• Masters degree preferred.