Kaiser Permanente Medicaid Director - Rockville, MD in Rockville, Maryland
Accountable for the development and overall performance of the Medicaid line of business for the Kaiser Permanente Mid Atlantic States (KPMAS) region. Develops an annual strategic plan and updates Executive Sponsorship on strategic issues/developments, business performance, and progress against objectives. Strategically manages external business relationships, product development, administrative processes, interdepartmental communication, and regulatory requirements. Accountable for building and sustaining effective relationships with state and local regulators. Represents MAS region on KP National Medicaid Program activities. The Director is accountable for overseeing all aspects of Medicaid programs including relationships with Maryland and Virginia state partners, contracting arrangements, product development, compliance with State and Federal Policies and requirements, partnerships with MAPMG, Administration, Program Office, and Provider Advisory Group.
Essential Responsibilities: - Operational Responsibilities: Manage the relationship and activities with functional areas as business, regulatory, operations, and IT; coordinate resource leverage/alignment with other initiatives throughout the organization; set key performance metrics and ensure that the Medicaid line of business is well-served; drive and manage continuous improvement initiatives related to Medicaid; monitor compliance, organize audits, and coordinate corrective actions plans. - Stakeholder Outreach: Represent KP with state regulators, departments, and representatives as well as local health departments, community-based organizations, etc.; proactively anticipate and respond to state and federal initiatives which impact Medicaid; assess Medicaid network development and recognize either ways to improve relationships with existing partners or new opportunities for provider partnerships; manage contractual arrangements with the states, transportation provider, SBHCs, DOHs, FQHCs, CSBs, etc. - Organizational Collaboration: Build relationships with KP Program Office and ensure that the Program Office is appropriately notified of KPMAS Medicaid activities; manage relationships and collaborations with MAPMG, including administration of the Provider Advisory Group. - Management: Manages a team of Medicaid professionals and is accountable for managing and developing performance to meet department and regional strategies.
Qualifications: Basic Qualifications: Experience - Minimum seven (7) years of management experience in Medicaid, health care or insurance industry. - Minimum five (5) years in product line management/health care delivery to special populations. Education - Bachelor's degree OR four (4) years of experience in a directly related field. - High School Diploma or General Education Development (GED) required. License, Certification, Registration - N/A
Additional Requirements: - Strong background working with Medicaid and/or Special Populations and unique health care needs. - Excellent negotiation skills, verbal/written communication skills. - Strong analytical and strategic planning skills. - Excellent public presentation skills. - Strong persuasive and interpersonal skills. - Knowledgeable of Medicaid health care delivery systems. - Knowledgeable of current trends in care management and industry standards related to care delivery to Medicaid population. - Demonstrated ability to build effective partnerships and influence others who may have different perspectives. - Must be a decisive, results-oriented manager or people. Must excel in developing a highly focused, cohesive team of professionals who are comfortable working in a team environment. - Demonstrated ability to work in a highly matrixed environment. Strong collaborative and team skills.
Preferred Qualifications: - Experience with budgeting' state and federal compliance; state and federal policies and laws. - MBA, MSN, or master's in public health, health care administration strongly preferred. - Extensive knowledge of Medicaid health care delivery systems preferred. - Extensive knowledge of current trends in care management and industry standards related to care delivery to Medicaid population preferred.
COMPANY Kaiser Permanente
TITLE Medicaid Director - Rockville, MD
LOCATION Rockville, MD