Careers

About this role: 

The Chief, Capitated Rates Development Division (CRDD), leads rate-setting activities for Medi-Cal managed care plans (MCP) and Programs of All-Inclusive Care for the Elderly (PACE) organizations. Activities include implementing actuarial methods for establishing capitation rates and overseeing the development and implementation of policies and protocols for reimbursements. Additionally, the Chief, CRDD, ensures financial methodologies are consistent with the efficient delivery of quality health care and comply with state and federal laws, regulations, and rules.

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Posting Details

This position will function as the Deputy Director Program Analysis and MCO’s within the Medicaid Office of Finance. It will be accountable for ensuring and maintaining the programmatic and fiscal integrity of numerous processes performed by personnel and/or Contractors of the Management, Special Projects, Program Analysis and Managed Care Organizations (MSPM) Units of the Medical Care Programs (Medicaid), Office of Finance. This position will also be accountable for the supervision, performance evaluation, discipline, and oversight of the work for assigned staff.

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Posting Details

Our Vision

• Every New Mexican has access to affordable health care coverage through a coordinated and seamless health care system.

Our Mission

• We ensure that New Mexicans attain their highest level of health by providing whole-person, cost-effective, accessible, and high-quality health care and safety-net services.

Our Goals

• Leverage purchasing power and partnerships to create innovative policies and models of comprehensive health care coverage that improve the health and well-being of New Mexicans and the workforce.
• Achieve health equity by addressing poverty, discrimination, and lack of resources, building a New Mexico where everyone thrives.
• Implement innovative technology and data-driven decision-making to provide unparalleled, convenient access to services and information.
• Build the best team in state government by supporting employees’ continuous growth and wellness.

Why does the job exist?

The Medicaid Compliance Bureau Chief will:

• Establish and monitor an effective compliance program for The Medical Assistance Division (MAD);
• Oversee the contracted Medicaid Managed Care Organizations;
• Implement all necessary actions to ensure achievement of the objectives of an effective compliance, oversight and policy program, including compliance with all relevant federal and state regulations as well as the Medicaid Managed Care Contract;
• Provide leadership to maintain compliance with federal and state regulations;
• Work Medicaid Managed Care reporting and the Turquoise Care (New Mexico Medicaid Managed Care) contract;
• Identify potential areas of non-compliance and associated risks;
• Develop and implement corrective action plans to resolve problematic areas;
• Reports regularly to senior management on progress of compliance efforts;
• Coordinate with staff throughout the agency to track and follow up as federal regulations are issued and/or updated;
• Oversee staff interfacing with audits, compliance and federal partners.

To learn more and apply, click here.

Posting Details

Our Vision

• Every New Mexican has access to affordable health care coverage through a coordinated and seamless health care system.

Our Mission

• We ensure that New Mexicans attain their highest level of health by providing whole-person, cost-effective, accessible, and high-quality health care and safety-net services.

Our Goals

• Leverage purchasing power and partnerships to create innovative policies and models of comprehensive health care coverage that improve the health and well-being of New Mexicans and the workforce.
• Achieve health equity by addressing poverty, discrimination, and lack of resources, building a New Mexico where everyone thrives.
• Implement innovative technology and data-driven decision-making to provide unparalleled, convenient access to services and information.
• Build the best team in state government by supporting employees’ continuous growth and wellness.

Why does the job exist?

The Gen I / Assistant Deputy Director will:

• Provide leadership in the strategic management and operational oversight governing Medicaid services within New Mexico Health Care Authority (HCA);
• Provide direct support to Medicaid’s Senior Deputy Director to ensure that the state’s Medicaid program operates efficiently, complies with state and federal regulations, aligns with legislative and stakeholder priorities, as well as supervision and leadership of key division bureaus and sections.

To learn more and apply, click here.