Position: Chief Medical Director, Division of Medicaid and Long-Term Care
The Nebraska Division of Medicaid and Long-Term Care is seeking a motivated and energetic individual to serve as its senior clinical and quality leader. This division has an annual budget of over $2.5 billion and is responsible for the provision of health coverage to nearly 240,000 Nebraskans through Medicaid and the Children’s Health Insurance Program. Reporting to the Governor appointed Director of Medicaid & Long-Term Care; the medical director will direct clinical staff, provide clinical decision-making for the program, and play a leading role in developing and leading the program’s new population health and analytics strategy focused on the Quadruple Aim. He or she will be expected to work with the Medicaid managed care organizations (MCOs) and oversee the medical management of the division to improve the patient experience of care, the provider experience, the health of populations served, and to reduce the per capita cost of care. The division has partnered with Nebraska Health Information Initiative (NEHII), a nonprofit health information exchange, to connect all Medicaid and long-term care providers to the HIE and develop an analytics tool focused on quality and performance improvement. The new Medical Director for the division will work closely with NEHII to leverage it’s network, and enhance it’s analytic capabilities. NEHII, a non profit, is the state designated health information exchange, state prescription drug monitoring program (PDMP) administrator, and a data analytics company designed to share clinical administrative data among providers Nebraska and neighboring states; it’s purpose is to achieve health care transformation through community betterment collaboration while protecting the security and privacy of medical information.
The Department of Health and Human Services (DHHS) team contributes to the lives and health of Nebraskans every day; its mission – “Helping people live better lives” – provides the motivation to make a difference. Some DHHS programs impact all Nebraskans, such as educating and protecting residents through public health activities like ensuring clean and safe drinking water and licensing and certifying all health care professionals; DHHS also touches the state’s most vulnerable citizens with services that assist the elderly, low-income residents, the disabled, abused and neglected children, and vulnerable adults. DHHS is Nebraska’s largest state agency and is responsible for nearly one-third of state government, in terms of teammates and budget. It is comprised of five divisions, seven facilities, and eight operational areas. The five division directors, who are appointed by the governor and confirmed by the legislature, report to the chief executive officer; these divisions are: Behavioral Health, Children and Family Services, Developmental Disabilities, Medicaid and Long-Term Care, and Public Health.
The Division of Medicaid and Long-Term Care (MLTC) is the largest division within DHHS, representing 71% of its overall budget and encompassing Medicaid and the Children’s Health Insurance Program, Home and Community Services for Aging and Persons with Disabilities, and the State Unit on Aging. Medicaid funds for healthcare services are available to eligible elderly, persons with disabilities, low-income pregnant women, and children and their parents, covering more than one in every 10 Nebraskans. MLTC administers non-institutional home and community-based waivers for the aged, adults and children with disabilities, and infants and toddlers with special needs, and is responsible for Medicaid eligibility determination, policy, provider enrollment, rate setting and reimbursement activities, claims processing, and program integrity activities. Medicaid in Nebraska is delivered through managed care in the Heritage Health program. Nebraska Medicaid contracts with three managed care organizations (MCOs): Nebraska Total Care, United Healthcare Community Plan, and WellCare of Nebraska.
Lincoln is the capital of Nebraska and the county seat of Lancaster County; with a population of approximately 284,750, it is the second-most populous city in Nebraska. It is the economic and cultural anchor of a substantially larger metropolitan area in the southeastern part of the state called the Lincoln Metropolitan and Lincoln-Beatrice Combined Statistical Areas, home to approximately 353,120 residents. As the city is the seat of government for the state of Nebraska, the state and federal government are major employers; the University of Nebraska, founded in 1867, is the city’s third-largest employer, with other primary employers falling within the service and manufacturing industries, including a growing high-tech sector – the region makes up part of what is known as the greater Midwest Silicon Prairie. Lincoln has been ranked fourth on Forbes’ list of “Best Places for Business and Careers,” first among NerdWallet’s “Best Cities for Job Seekers,” and second on SmartAsset’s list of “Cities with the Best Work/Life Balance.” The city has also been named among the top 10 best places to retire by U.S. News & World Report.
EXPRESSION OF INTEREST AND CONTACT:
Derek Castaneda (Managing Partner), and Joe Johnston (Principal) of Quick Leonard Kieffer will interview prospective candidates. Interested and qualified candidates may contact Quick Leonard Kieffer at 555 West Jackson Boulevard, 2nd Floor, Chicago, IL 60661; phone (312) 876-9800; or e-mail email@example.com or firstname.lastname@example.org.
View the full details of this job opportunity and apply now through the Quick Leonard Kieffer site.
The Idaho Department of Health and Welfare, Division of Medicaid has an exciting career opportunity for a dynamic forward-thinking, innovative professional with strong communication skills who can excel under pressure as a Deputy Administrator. This individual will report to the Division Administrator and will have primary oversight of new and emerging programs; federal and state policy work, including State Plan Amendments, waivers, rules, legislation and project management.
We are seeking a self-directed leader versed in managing multiple programs, dealing with ambiguity, and providing vision and strategic leadership in a public environment. The ideal candidate will be adept at cultivating strong stakeholder relations and managing programs that are complex, diverse, and cross assorted subject areas.
The Division of Medicaid manages healthcare services ensuring comprehensive care is accessible to the most vulnerable residents of our state, promoting an outcome-based, efficient health and human services delivery system. We serve over 300,000 children, low-income families, seniors, and people with disabilities through several Medicaid programs.
We offer a competitive benefits package which includes excellent medical, dental and vision insurance; generous vacation and sick leave accrual beginning as soon as you start; ten paid holidays a year; participation in one of the nation’s best state retirement systems; multiple savings plans and optional 401K; life insurance; wellness programs; ongoing training opportunities; and more.
Full posting here.
The Department of Health Care Services (DHCS) is looking for a highly skilled, exceptionally motivated individual to lead as the Chief, Medi-Cal Behavioral Health Division (MCBHD). If you are interested in working with a team who is dedicated to preserve and improve the overall health and well-being of all Californians, this Department and job opportunity are for you.
Under the direction of the Chief Deputy Director, Health Care Programs, the Chief, MCBHD, serves as the central point for policy development and interpretation for Medi-Cal mental health services and substance use disorder (SUD) services for DHCS. Specifically, the Chief, MCBHD, is responsible for planning, organizing, supervising, policy formulation, and non-fiscal program operations for all Medi-Cal community mental health services and Medi-Cal community SUD services; administration of the Specialty Mental Health Services 1915(b) waiver and the Drug Medi-Cal Organized Delivery Systems component of the 1115 Waiver; oversight and implementation of all Medi-Cal State Plan services related to specialty mental health and SUD services; development of any amendments to the State Plan or waivers related to policy decisions in Medi-Cal funded mental health and SUD services; assuring DHCS compliance with its responsibilities under federal and state law for Medi-Cal mental health and substance use disorder services; and oversight and contract management of county Mental Health Plans, Organized Delivery System Waiver organizations, and county SUD state plan programs. The Chief, MCBHD ,will also be responsible for working collaboratively with the Deputy Director of Behavioral Health Services as well as the Chief, Behavior Health Financing Division, given their respective roles in the policy and financing of behavioral health services.
Full description and application here.
Kansas Department of Health and Environment:
Our agency head is Secretary Lee Norman, who was appointed by Gov. Kelly in Jan 2019. We are made up for three divisions: Public Health, Environment, and Health care finance (which includes KanCare). We are the only agency in the nation to have these three entities under one roof. This allows us to take a holistic approach to the health and well-being of all Kansans.
About the Position:
Who can apply: Anyone (External)
Classified/Unclassified Service: Unclassified
Work Schedule: Monday-Friday 8am-5pm (Flexible schedules available)
Eligible to Receive Benefits: Yes
Veterans’ Preference Eligible: Yes
Comprehensive medical, mental, dental, vision, and additional coverage
Sick & Vacation leave
Work-Life Balance programs: parental leave, military leave, jury leave, funeral leave
Paid State Holidays
Fitness Centers in select locations
Employee discounts with the STAR Program
Retirement and deferred compensation programs
Infant at work program
Position Summary & Responsibilities:
This Deputy Secretary for Health Care Finance position (K0221729) is responsible for administering KanCare and the State Employee Health and Benefits Plan to deliver on the mission and vision of Division of Health Care Finance. Develops strategic vision and effectively communicates to all levels of the organization. Establishes functional goals and objectives supported by performance measures to track results. Evaluates program capabilities to ensure adequate resource allocation. Directs policy evaluation, development and administration. Drives innovative and alternative models for enhancing program operations and cost effectiveness. Retains, recruits and develops an effective team of professionals to achieve DHCF objectives.
Job Responsibilities may include but are not limited to the following:
Requires specialized knowledge of Medicaid, state government, strategic planning and agency administration. Must be able to work under minimal supervision with extensive latitude for the use of initiative and independent judgment. Knowledge of state and federal laws and regulations specifically knowledge of CMS regulations and processes for state plan, institutional and waiver programs. Knowledge of the principles and practices of public administration and management or health management and finance. Demonstrated ability to direct and organize program activities; to establish program goals and objectives that support the strategic plan; to identify problems, evaluate alternatives and implement effective solutions; to develop and evaluate policies and procedures; to direct the development of agency policies and procedures; to prepare concise reports; to make presentations and testify at hearings; and to plan, assign, and/or supervise the work of others.
For the full job description please contact the recruiter listed below.
High School or GED
Master’s degree from a recognized college or university with a major study in public administration, health policy, finance, public health, public policy, law or a related field of study, and seven years of work experience in public administration, policy administration, business, management or a related field. OR
Bachelor’s degree from a recognized college or university with a major study in public administration, health policy, finance, public health, public policy, law or a related field of study, and ten years of work experience in public administration, policy administration, business, management or a related field.
Valid Driver’s License – Incumbent is required to have and maintain a valid driver’s license when operating a state vehicle, a private vehicle, or a rental vehicle for the benefit of the State.
Preference will be given to candidates with public administration, public health, law or health care policy background who have worked within a State and/or Federal medical assistance program.
Word, Excel, PowerPoint, Access
Proofreading, editing, attention to detail
Advanced problem solving and analytical skills
Recruiter Contact Information:
Name: Mary McAferty
Mailing Address: 1000 SW Jackson St. Suite 580 Topeka, KS 66612
Required documents for this application to be complete:
On the My Job Applications page, verify these documents are present and valid. Upload or delete and upload new if needed.
o Tax Clearance Certificate
o DD214 (if you are claiming Veteran’s Preference)
Inside your Job Application upload these documents:
o Resume (or choose existing if you have one)
o Cover Letter
Kansas Tax Clearance Certificate Required: Each applicant (even non- residents) applying for a State of Kansas job vacancy must obtain a valid Kansas Certificate of Tax Clearance by accessing the Kansas Department of Revenue’s website. A Tax Clearance is a comprehensive tax account review to determine and ensure that an individual’s account is compliant with all primary Kansas Tax Laws. A Tax Clearance expires every 90 days. All applicants, including current state employees, are responsible for submitting a valid certificate with all other application materials to the hiring agency. This is in accordance with Executive Order 2004-03. If you need assistance with the tax clearance, please contact 785-296-3199.
Visit the Tax Clearance site for more information and where to obtain this Kansas Department of Revenue document.
Job Application Process:
Sign in to your existing account or Register for a new one to apply.
Complete or review your contact information on the My Contact Information page.
Upload documents listed in the Required Documents section of the job posting to the appropriate location.
Check your email and My Job Notifications for written communications from the Recruiter.
• Email – sent to the preferred email listed on the My Contact Information page
• Notifications – view the Careers – My Job Notifications page
How to Claim Veterans Preference:
Veterans’ Preference Eligible (VPE): Former military personnel or their spouse that have been verified as a “veteran”; under K.S.A. 73-201 will receive an interview if they meet the minimum competency factors of the position. The veterans’ preference laws do not guarantee the veteran a job. Positions are filled with the best qualified candidate as determine by the hiring manager.
Learn more about claiming Veteran’s Preference
Equal Employment Opportunity:
The State of Kansas is an Equal Opportunity Employer. We value diversity, equity, and inclusion as essential elements that create and foster a welcoming workplace. All qualified persons will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, political affiliation, disability or any other factor unrelated to the essential functions of the job.
If you wish to identify yourself as a qualified person with a disability under the Americans with Disabilities Act and would like to request an accommodation, please address the request to the recruiter.
This Director of Program Finance position (K0221730) develops and manages the Division’s budget which includes narrative, projecting costs and revenues, new fee components, enhancements, decrements, appeals and amendments. Scope includes all Medicaid items for the division (Title XIX, Title XXI, Working Healthy and other grant and waiver programs), the State Employee Health Plan, as well as the State Self Insurance Fund. Communicates directly with KDHE’s Office of the Secretary, Chief Financial Officer and Division of Budget Analyst through various means to assist them in understanding allocations requested and revisions. Continually reviews program and caseload expenditures and applies changes made to current budget to identify current or potential problems, funding shortfalls or inconsistencies between expenditures and budget amounts.
Job Responsibilities may include but are not limited to the following:
Provides leadership to the Program Finance and Informatics group staff to achieve DHCF program goals. Develops and supervises staff to collect, cultivate and share program and health care data and information with KDHE staff and other State agencies, policymakers and external stakeholders to support efficient program operations. Safeguards personally identifiable, confidential and/or legally protected health care information. Disseminates data and information at the appropriate level of detail and identification to those, inside and outside the Agency, who would benefit from the information or who can contribute to the health of the state or improvement of DHCF programs.
For the full job description please click here.
TennCare’s Medical Office is at the forefront of leading innovation and building clinical care models to support TennCare’s mission. The Division of Quality Improvement falls under the direction of the Chief Medical Office. Operationally, the Quality Improvement Division works closely with several TennCare divisions to lead development and execution of a comprehensive quality strategy. Additionally the Quality Improvement team plays a strategic role in TennCare initiatives focused on improving clinical care and outcomes for TennCare members, including primary care transformation and population health. Externally, the Quality Improvement Division works closely with TennCare’s contracted organizations and other state agencies to provide improvement of quality performance and data reporting for TennCare members. The Quality Improvement Data Analytics Director will be a key leader on the Quality Improvement (QI) Team reporting to the Chief Quality Officer.
Full posting and application can be found: Quality Improvement Data Analytics Director Executive Service Job Post, FINAL, 05.07
UNCLASSIFIED SUPPLEMENTAL JOB DESCRIPTION
Title: Deputy Medicaid Director Position Number: 9U404
Letter Grade: GG Date of Last Amendment: 2/12/19
SCOPE OF WORK: Administers the strategy, goals, and objectives of the Division of Medicaid Services (DMS) in close coordination with the Medicaid Director. Authorizes and directs senior-level policy development, evaluation, and administration; program operations; and the implementation of DMS policies and procedures. Includes establishing goals and objectives in support of the DMS strategic plan, identifying and evaluating alternatives for enhancing program and business operations, and leading an effective team of professional staff to achieve DMS objectives. Acts as Medicaid Director in the absence of the Director
REPORTS TO: Director, Division of Medicaid Services
DIRECT REPORTS: 9U390, Provider Relations Manager; 40324, Administrator IV – Medicaid Benefits Management; 30278, Administrator IV – Pharmacy Services; 9U421, Dental Director
• In coordination with the Medicaid Director, ensures that DMS strategy and operations align with the goals and objectives of the Division and Department, including monitoring and evaluating operational activities for compliance with regulatory mandates, efficient and effective allocation of Division resources, and the achievement of evidence-based, measurable outcomes. Continuously looks toward opportunities for generating alignment and integration across the Department and Division.
• Assists the Medicaid Director regarding DMS operations with a focus on the Medicaid Care Management Program, Federal Waivers for the Medicaid Program, the State Plan and amendments, and State and Federal level rule-making.
• Manages assigned day-to-day Division operations in the areas of program operations, services, contracts, financial management, and budget. Oversees the development and implementation of strategies to improve business and program operations. Authorizes internal operational policies and procedures and reviews recommendations for enhancements.
• Independently administers assigned program objectives and directs staff activities to accomplish desired results.
• Assists DMS Director with planning and developing legislative strategy and activities, drafts legislation, and presents testimony at legislative hearings.
• Administers and coordinates policy and program efforts with other DHHS sections/units to ensure agency compliance with federal and state regulations by ensuring coordination and maintenance of NH administrative rules and State Plan Amendments that deal with Medicaid benefits.
• Provides direct supervision and professional development guidance to subordinate managers and staff. Evaluates work performance, assesses training needs, and assures timely performance evaluations are conducted.
• Analyzes, interprets, and integrates program, regulatory, financial and outcome data, and metrics to inform planning efforts and decision making. Prepares reports and communicates findings and recommendations to the Director.
• Acts as the official representative of the Department and Division. Meets with government officials, medical professionals, and others to explain and develop DMS policy and operating positions. Provides information and guidance to state agencies, the legislature, Governor’s Office and the general public regarding agency activities and responsibilities. Presents testimony at legislative and regulatory hearings to provide information and speak in support of agency goals.
• Frequently interfaces with federal and state agencies, community partners, and constituents including the Centers for Medicare and Medicaid Services. Troubleshoots and resolves received/referred issues from DMS stakeholders and beneficiaries.
• Acts as Medicaid Director in the absence of the Director.
EDUCATION and EXPERIENCE:
Experience and Education
Master’s degree from a recognized college or university with a major study in public administration, health policy, finance, public health, public policy, law or a related field of study, and eight years of work experience in public administration, policy administration, business, management or a related field.
Bachelor’s degree from a recognized college or university with a major study in public administration, health policy, finance, public health, public policy, law or a related field of study, and nine years of work experience in public administration, policy administration, business, management or a related field.
LICENSE/CERTIFICATION: Valid driver’s license and/or access to transportation for travel as required by the position duties.
SPECIAL REQUIREMENTS: Requires specialized knowledge of Medicaid, state government, strategic planning and agency administration. Must be able to work under minimal supervision with extensive latitude for the use of initiative and independent judgment. Knowledge of local, state, and federal laws and regulations specifically knowledge of CMS regulations and processes for state plan, institutional and waiver programs. Knowledge of the principles and practices of public administration and management or health management and finance. Demonstrated ability to direct and organize program activities; to establish program goals and objectives that support the strategic plan; to identify problems, evaluate alternatives and implement effective solutions; to develop and evaluate policies and procedures; to direct the development of agency policies and procedures; to prepare concise reports; to make presentations and testify at hearings; and to plan, assign, and/or supervise the work of others.
PREFERRED QUALIFICATIONS: Preference will be given to candidates with public administration, public health, law or health care policy background who have worked within a State and/or Federal medical assistance program.
DISCLAIMER STATEMENT: The supplemental job description lists typical examples of work and is not intended to include every job duty and responsibility specific to a position. Any employee may be required to perform other related duties not listed on the supplemental job description provided that such duties are characteristic of that classification.
You may apply on-line at the following link:
or Applications may be mailed to:
Department of Health & Human Services
129 Pleasant Street
Concord NH 03301
The Department of Health Care Services (DHCS) is seeking a highly skilled, exceptionally motivated individual to lead as the Deputy Director for Fiscal and Chief Financial Officer (CFO). If you are interested in working with a team who is dedicated to preserving and improving the overall health and well-being of all Californians, this Department and job opportunity are for you.
Under the general direction of the Chief Deputy Director, Policy and Program Support, the Deputy Director for Fiscal and CFO provides leadership and policy direction to the Department’s fiscal forecasting/estimating, budget, and accounting/financial reporting functions; advises the directorate, executive staff, and DHCS programs on fiscal operations; and represents DHCS internally and externally on fiscal matters as necessary.
For additional information and application, click here.
Louisiana Medicaid is recruiting for a Deputy Director for Eligibility.
This Medicaid Deputy Director position plans, directs and oversees the Medicaid Eligibility Division which is compromised of the Eligibility Field Operations and Eligibility Program Operations sections. These sections are responsible for the management, operations, oversight, and support of the Medicaid regional offices, Medicaid Customer Service Unit, Medicaid eligibility policy and procedures, training, Application Centers, outreach and outstation program, Payment Error Rate Measurement, Post Eligibility Review, eligibility reporting, and compliance with federal and state regulations and authorities that govern the administration of the Medicaid Program.
This position will represent LDH and the Medicaid Director at state-level tables focused on Medicaid eligibility and enrollment. Candidates must possess a strong management of people as well as the use of innovations, process improvements, and change management to improve and modernize eligibility policies, systems, business operations and workforce capacity.
Click here for the full job description and online application.
Position Title: Medicaid Director
Job Opening ID: 3012535
Closing Date: April 13, 2019
Hiring Range: $8,051 – $13,418 per month
Status: Full-time, Regular
City: Bismarck, ND
At the State of North Dakota, our mission is to empower people, improve lives and inspire success. To achieve this mission, the State of North Dakota has over 70 state agencies which, along with the ND University System, employ approximately 15,000 team members. Our talented workforce is committed to providing exceptional services to the citizens of North Dakota. We make a difference, whether working to keep citizens safe, supporting the vulnerable, educating our future leaders, serving as responsible stewards of our resources, assisting with public policy and everything in between!
Summary of Work:
This position is responsible for administration of Medicaid, Medicaid Expansion, and the Children’s Health Insurance Program. The Division has approximately 50 full time staff responsible for program oversight and direction, strategy and policy development, utilization review, program integrity, research and exploration of innovations, and implementation of federal and state initiatives and mandates. The Division and Medicaid biennial budget exceeds $2 billion.
Requires a bachelor’s degree and five years of senior management level experience in the administration of Medicaid programs, other major human service funding, or reimbursement programs (such as Public Assistance, Supplemental Nutrition Assistance Program (SNAP), Child Support, etc.) OR a bachelor’s degree and five years of senior level management experience in healthcare administration including extensive experience with Medicaid regulations and reimbursement.
Experience must have included program implementation and management, supervision of professional level staff, budget development, and management. This experience must be included in a resume or the job duties of the online application in order to be considered.
• Please complete the online application and provide a resume and cover letter with details on how your education, work experience, and skills qualify you for this position.
• The Department of Human Services does not offer or provide sponsorships. Applicants must be legally authorized to work in the United States.
For more information or if you need an accommodation, Please Contact: Marcie Wuitschick
Telephone Number: (701) 328-1290
TTY Number: ND Relay Service 1-800-366-6888 (text); 1-800-366-6889 (voice)
If you are experiencing technical difficulties with the Application Process or uploading attachments , please contact email@example.com or (701)328-3290
Equal Opportunity Employer
The state of North Dakota and this hiring agency do not discriminate on the basis of race, color, national origin, sex, religion, age, genetics or disability in employment or the provision of services, and complies with the provisions of the North Dakota Human Rights Act.
The Virginia Department of Medical Assistance Services is seeking a dynamic division director of the new Creating Opportunities for Medicaid Participants to Achieve Self-Sufficiency (COMPASS) Division.
The full posting and application can be found: https://virginiajobs.peopleadmin.com/postings/141969
The ideal candidate for this position will have experience in a mid-to-large public or private sector health care organization with a broad understanding of health care financing. The Deputy Chief Financial Officer (DCFO) will be joining a high-performance team headed by the Chief Financial Officer (CFO) that is striving to support the Health Care Authority with its mission to provide high-quality health care through innovative health policies and purchasing strategies. The DCFO must be a confident professional with the ability to exercise a high degree of common sense and sound judgment. Desired personal characteristics include strong communication skills, effective decision-making, experience in skillfully mentoring and developing staff, and the ability to present clear recommendations and timely advice to the CFO.
See full listing and application here.
This position functions as the Deputy Director for the Medical Services Administration, responsible for the development, implementation, and presentation of Medicaid programs. The person in this position will act as the Director of Medicaid and will be responsible for all policy and operations for the Medicaid Programs for the State of Michigan. The individual is charged with strengthening Michiganders’ health outcomes, improving Medicaid’s cost effectiveness, and innovating in service of Michigan patients and taxpayers. Specifically, the person will be responsible for leading innovation efforts in the realms of payment reform, quality oversight, care coordination, social determinants of health, overall system accountability. In addition, the person will lead engagement and coordination with other stakeholders throughout the State’s healthcare landscape, including key personnel within MDHHS, leaders in other social service agencies, and health care payors and providers in the private sector.
See full posting and application here.
Louisiana Medicaid Chief Operating Officer
The Medicaid Chief Operating Officer ensures Medicaid agency functions are optimized and aligned to deliver on the Department’s strategic goals and tactical objectives, ensuring compliance with Federal and State laws, rules and regulations, and stewardship of public resources while providing access to the highest quality of service and care to Louisiana Medicaid enrollees. This position requires in-depth knowledge of Medicaid including its critical issues and major challenges.
- Overall responsibility for facilitating the coordination, integration and execution of Medicaid policies and activities across Medicaid components, including new program initiatives. Directs, aligns, and oversees Medicaid’s ongoing operational strategies, policies, objectives, and initiatives.
- Tracks and monitors Medicaid performance and intervenes, as appropriate, to ensure key milestones/deliverables are successfully achieved. Keeps the Undersecretary and Medicaid Director advised of the status of significant federal and state initiatives and programs that affect beneficiaries and/or Medicaid and makes recommendations regarding necessary corrective actions.
- Promotes accountability, communication, coordination, and facilitation of cooperative decision-making among LDH senior leadership on management, operational and programmatic cross-cutting issues.
- Provide direct supervision to the Medicaid Eligibility Deputy Director; the Medicaid Policy, Waivers & Public Affairs Deputy Director; the Medicaid Program Operations & Compliance Deputy Director; the Chief Medical Officer and the Chief Clinical Innovations Officer.
- Applies current knowledge and understanding of Medicaid regulations, industry trends, current best practices, new developments, and applicable laws regarding assigned departments for operational and financial effectiveness. Ensures regulatory compliance for all areas of responsibility.
- Recognizes, adopts, and implements continuous quality improvement (CQI) best practices and metrics to obtain desired strategic and tactical results.
- Chair the Medicaid Financial Review Committee, including ensuring any Medicaid item that has a budget impact is evaluated and recorded.
Strategic Planning Responsibilities:
- Participates in the strategic and long-range planning of the organization. Integrates the long-range plans with operational plans and priorities. Provides leadership in determining programmatic, technical, and operational goals and develops processes to achieve these goals.
- In partnership with LDH and Medicaid Finance, Executive and Operational leadership, facilitates Medicaid’s portfolio management approach to decision making and resource allocation processes.
Sister Agency Responsibilities:
- Provides Medicaid’s executive leadership point of contact to LDH sister agency operations, including facilitating all required interaction and coordination between Medicaid and other sister agencies.
- Develops strategy and plans for implementing new objectives that partner Medicaid and sister agencies, including collaborating internally and externally to establish direction and enhance alliances to accomplish strategic results.
The Civil Service website where jobs are posted is https://www.governmentjobs.com/careers/louisiana
Chief Financial Officer – Medicaid Deputy Director
The mission of the Louisiana Department of Health (LDH) is to protect and promote health and to ensure access to medical, preventive and rehabilitative services for all citizens of the State of Louisiana. LDH is dedicated to fulfilling its mission through direct provision of quality services, the development and stimulation of services of others, and the utilization of available resources in the most effective manner.
This position is in the Bureau of Health Services Financing (BHSF), Louisiana’s single state Medicaid agency within the Louisiana Department of Health (LDH). The Louisiana Medicaid Program, which provides healthcare services to low income individuals, has an annual budget of approximately $12.5 billion dollars comprising almost 25% of the entire state’s operating budget, and provides services to approximately 1.6 million recipients annually. The program is a state and federal partnership financed with a combination of state and federal funds and governed by a complex body of state and federal laws, policies, regulations and guidelines.
The Medicaid Deputy Director for Finance is one of five assistants to the Medicaid Director, and a member of the Director’s Executive Team. This position directs the activities of four (4) Medicaid Program Manager 4s (Section Chiefs) involved in Medicaid Vendor Administration within LDH. These four sections are Financial Management and Operations, Managed Care Finance and Hospital program, Rate Setting and Audit and Program Integrity.
Duties and responsibilities for this position include but are not limited to:
25% Participates at the highest levels in the LDH Management in planning and developing agency initiatives and coordination of program development in the other Program offices, with Medicaid funding requirements, to assure the appropriate use of Medicaid funds. This requires regular (daily) communication with the Medicaid Director and weekly communication with the Secretary, Deputy Secretary and Assistant Secretaries of the Program Offices.
25% Independently evaluates program effectiveness and efficiency and makes needed changes or makes recommendations to the Medicaid Director for changes in staffing and human resource utilizations. Staffing changes within the purview of this position can be made independently with only the broadest direction from the Director.
20% Works closely with Section Chiefs (Medicaid Program Manager 4) and other Program Managers on a daily basis to define their work priorities, coordinate work activities and monitor progress of assignments.
Develops performance appraisal for directly supervised staff.
Interviews and makes recommendations for hiring staff; oversees training and development; monitors performance to ensure programmatic goals are achieved.
Undertakes numerous special studies and projects at direction of the Secretary, Undersecretary and Medicaid Director. Prepares a report of findings and makes recommendations as a result of findings. A number of these studies cross over into areas outside of Medicaid.
15% Participates in numerous task forces either as chairman or as member to develop Medicaid programs, policies and procedures.
10% Meets with government officials, Medical professionals and others to negotiate, explain, or present the agency position on issues relating to Medicaid program requirements, program abuse, provider fraud or new and changed programs which might impact some member of the groups, constituency or organizations. These are often sensitive meetings requiring a high level of finesse and restraint in assuring that the Medicaid Program issues are well understood.
Testifies on an as needed basis at the Legislative Committee for Health and Welfare and Appropriations, which includes House and Senate Committees and Joint Committees.
5% Stays abreast with development of trends and practices in Health Care Financing on a national scale so that plans may be developed to improve the Medical Vendor Program. This includes actions being taken by U.S. Congress. This is done through reading of numerous periodicals and correspondence from the Centers for Medicare and Medicaid Services, and other nationally recognized or peer reviewed literature.
Performs other assignments as required by Executive Management of LDH.
The Civil Service website where jobs are posted is https://www.governmentjobs.com/careers/louisiana
The main purpose of this position is to assist the Maryland Medicaid Director on behalf of the Health Secretary to lead and manage the $13 billion Medicaid program that includes health and home and community based services for 1.4 million Marylanders. It is the largest health services plan in the state of Maryland covering 1 in 5 Marylanders. This position will act as the Medicaid Director, when the Medicaid Director is unavailable.
This position develops and leads innovation in the Medicaid program. This innovation will contribute to the Total Cost of Care objectives that support the All Payer Model. Innovation will improve quality and lower cost through process change and re-engineering. The position applies principles of insurance risk and understanding of pharmacy supply chain to manage costs. It also uses policy research and informatics to drive innovation and change like behavioral health integration.
Deputy Director for Health Plan Operations
The Office of the Director (OOD) is looking for a highly motivated individual to join our team as a Deputy Director for Health Plan Operations. The Deputy Director for Health Plan Operations will be responsible for administration of the diverse day-to-day business and programmatic activities of the Agency.This position will oversee the work of senior level management including the Division of Healthcare Management (finance, rate development, data, clinical, operations and compliance), Fee-For-Service Management and project management.
Deputy Director for Business Operations
The Office of the Director (OOD) is looking for a highly motivated individual to join our team as a Deputy Director for Business Operations. The Deputy Director for Business Operations will be responsible for administration of the diverse day-to-day business and programmatic activities of the Agency.This position will oversee the work of senior level management including the Division of Business and Finance, Division of Member Services, Information Services Division, Office of Continuous Improvement and project management.
The Division Director of Medicaid Program Operations and Integrity is responsible for implementing a combination of fee-for-service (FFS), managed care policy and programs, and is structured to promote the eligibility, integration, and development of appropriate, high-quality health care services (medical health, mental health, and recovery health).
The incumbent is responsible for the developing, implementing and managing statewide health care policy in line with both state and federal requirements. Compliance with federal law ensures funding of state-only health care programs. Create a value based business model that promotes delivery of patient centered care; ensure informed decision making at point of care, increase prevention services and reduce administrative costs through efficient processing.
As the expert provide testimony for legislature regarding health care services and oversee key implementation of recent federal legislation, including benefit administration and procurement for Washington residents. Direct key communication regarding policy issues with the legislature, Governor’s office, and interest groups; develops, implements and manages projects, initiatives and programs as directed by legislature or Governor’s office related to health care services.
For more information and to apply, follow the link Division Director Medicaid Program Operations and Integrity. Salary up to $137,964 annually.
Medicaid Eligibility Division Deputy Director
The Deputy Director for Eligibility is one of seven members of the Medicaid Director’s Executive Management Team, including 5 Deputies (Eligibility, Systems, Program Operations, Finance, and Policy/Governing Authorities), a Chief Medical Officer, and a Chief of Staff. The Louisiana Medicaid program, also known as the Bureau of Health Services Financing (BHSF), provides health coverage for nearly 1.7 million Louisianans and is responsible for $12.5 billion dollar annual spend, accounting for nearly half of the State’s total operating budget. This position represents LDH and the Medicaid Director at state-level forums focused on Medicaid eligibility and enrollment and the use of innovation and process improvements to support increasing eligibility field staff workload and enrollment.
The Medicaid agency sets the policy for Medicaid and State Children`s Health Insurance Program (SCHIP) eligibility and enrollment. This position oversees all aspects of the Louisiana Children’s Health Insurance Program (LaCHIP), which provides health coverage to children under age 19 from families with income too high to qualify for Medicaid but who cannot afford health insurance. The Medicaid Eligibility division is responsible for processing applications for benefits annually and completing annual renewals of eligibility for enrollees.
This position directly oversees the activities of two (2) Medicaid Program Manager 4s (Section Chiefs) involved in administration of the BHSF within LDH and indirectly supervises approximately 700 employees and approximately 300 eligibility support positions through a staff augmentation support contract with the University of New Orleans (UNO). The sections included in the Eligibility Division include Eligibility Field Operations (EFO) and Eligibility Program Operations (EPO). These sections are responsible for the management, operations, oversight, and support of the Medicaid regional offices, Medicaid Customer Service Unit (CSU), Medicaid eligibility policy and procedures, training, Application Centers, outreach and outstation program, Payment Error Rate Measurement (PERM), Post Eligibility Review (PER), eligibility reporting, and compliance with federal and state regulations and authorities that govern the administration of the Medicaid Program.
Health Access Policy & Planning Chief – Waterbury Vermont
The Department of Vermont Health Access, which administers Vermont Medicaid, seeks a dynamic team member to oversee the department’s legislative work and related communications. The incumbent will assess the impact of pending and enacted state legislation on the Medicaid program and health reform activities, and will work with the Commissioner to articulate direction and priorities for major legislative projects. During the legislative session this position acts as liaison between the legislature and Department and will coordinate responses to legislative mandates and reports following the session. The position may also serve as a spokesperson and key contact for other stakeholders and the media. For more information contact Cory Gustafson 802-241-0239 or Cory.Gustafson@vermont.gov Reference Job ID # 783 Location: Waterbury Vermont. Status: Permanent, Full Time. Application Deadline: January 20, 2019.
MEDICAID CHIEF OF STAFF POSITION DESCRIPTION
BHSF Mission and Scope
The Bureau of Health Services Financing (BHSF) is one of five agencies within the Louisiana Department of Health and is responsible for administration of the Louisiana Medicaid program. With an annual operating budget of $12.5 billion, BHSF provides health care coverage to 1.7 million Louisianans utilizing more than 900 staff in one central and ten regional offices. In order to carry out the above responsibilities, BHSF is organized into five divisions, which include: Eligibility, Systems, Finance, Policy, and Program Operations. This position supports the Medicaid Director position that has oversight and responsibility of all five divisions, as well as interfaces with the other agencies within the Louisiana Department of Health.
Position Mission and Scope
Due to the large scope of work that is encompassed in the administrative oversight of the Bureau of Health Services Financing (BHSF), this highly responsible management position will assist the Medicaid Director in directing the state’s Medicaid program. The incumbent is responsible for developing, directing, and supervising projects that are priority for Medicaid leadership. The incumbent will also serve as a special assistant and advisor to the Medicaid Director and Deputy Directors. The incumbent will need to maintain a flexible schedule, respond to changing priorities, and to multi-task as needed. The work performed demands a high degree of independence and initiative, requiring the incumbent to prioritize initiatives, develop work groups, lead project activities, troubleshoot and solve for obstacles and delays, implement and manage change and report and provide continuous accountability on project progress. Data analysis and presentation skills, along with advanced communication abilities, will be cornerstones of success for this incumbent. This position reports to the Medicaid Director.
20% Special Assistant and Strategic Advisor
- Supports Medicaid’s mission to advance the Triple Aim of better care, better health and lower cost by fostering and supporting collaborative partnerships across LDH, other state government offices and departments, and external stakeholders
- Attend meetings and/or legislative activities as a representative of Medicaid Director and Deputy Directors or with them as an agency representative to participate in discussions or problem solving sessions and to take summary notes and/or minutes and to provide updates or answer questions.
- Develop presentations, reports, white papers, talking points, and information briefs on various topics for use by the Medicaid Director and Deputy Directors to share with other administrators, legislators and other external stakeholders. May also make presentations on behalf of the agency.
50% Strategic Project Management
- Serves as special assistant and strategic advisor to the Medicaid Director
- Provide ongoing consultation and technical assistance to Medicaid executives and managers to collect data and information related to special projects, initiatives, legislation, breaking events or other priorities as they arise.
- Advise, manage and coordinate assigned agency priority projects, such as Big Bets, efficiency projects, and cross-sector or multi-agency collaborations, including:
- Developing clear objectives, timelines and work plans for accomplishing the objectives
- Forming and managing effective teams to execute the objectives in a timely manner
- Effectively holding all team members accountable and manage progress through excellent communication and project management skills, using proven methods for motivation an coaching success
- Responding proactively to programmatic challenges and coordinates quick resolution
- Preparing reports, memos, and presentations for Medicaid and LDH leadership providing progress updates, special topics, and outcomes of projects
20% Representative and Liaison
- Serve as liaison for Medicaid on statewide task forces, work groups, councils, and coalitions. Also undertakes, oversees, and directs special projects related to legislative action, budget efficiencies, studies, task forces, work groups, and other departmental and Office initiatives.
- Confer and interface with executive and high level officials of other state entities, such as the Department of Administration, the Department of State Civil Services, legislature, municipalities, local governing entities, and other bodies relevant to agency programs, priorities, and operational activities.
5% Emergency Preparedness
- Supports and serves in coordination and management of Emergency Operations during activation and as needed between events
5% Other duties as assigned
Responsible for the supervision of the Managed Care and Oversight division within the Rhode Island Medicaid Program. Plan, supervise, direct, coordinate and review the work of staff and provide management oversight of the work related to managed care and oversight activities. Within the Executive Office of Health and Human Services, Medicaid Division, to serve as the Deputy Director for Managed Care and Oversight responsible for overseeing managed care and oversight activities including those related to analysis, health system transformation, managed care, and policy research and regulatory oversight. Ensure the Medicaid Program acts as a value-based purchaser in its administration and oversight of the contracted managed care organizations. Further transform the Medicaid Program into a catalyst for payment reform and delivery system reform in Rhode Island. Responsible for the supervision of the Managed Care and Oversight division within the Rhode Island Medicaid Program. Plan, supervise, direct, coordinate and review the work of staff and provide management oversight of the work related to managed care and oversight activities. • Support projects across health and human services departments relating to key strategic and operational priorities connected with managed care and oversight activities. • Collaborate with other state agencies to ensure that issues related to managed care and oversight activities are accounted for in program development and execution. • Represent the Medicaid Program senior management team at various meetings with external stakeholders that address managed care and oversight activities. • Oversee the development and approval of the State’s 1115 Waiver extension request. • Oversee the planning and implementation of the Health System Transformation Project. • Implement managed care dashboards enhancing regulatory and contractual oversight of the Medicaid managed care health plans. • Advise the Medicaid Program Director on managed care and oversight issues. • Provide policy and regulatory guidance in support of Medicaid eligibility system compliance.
Position closes 12/17/18 – click link for full description: Deputy Medicaid Program Director, Managed Care and Oversight
Colorado Department of Health Care Policy and Financing: Executive Director
The position of Executive Director of the Department of Health Care Policy & Finance is given authority to set rules in connection with the policies and procedures governing the administration of the Department. Duties include overseeing Health First Colorado (Colorado’s Medicaid Program), Child Health Plan Plus, and other public health care programs for Coloradans who qualify.
This position includes acting on and overseeing the implementation of the Governor-Elect’s priorities to lower health care costs for families and small businesses, advocating for and creating policies that strive towards Universal Coverage, continue to integrate mental, behavioral and physical health, improving the delivery of care and treatment for Coloradans with intellectual, developmental, physical and acquired disabilities.
NAMD is pleased to announce a new contract opportunity to support its Leadership Development portfolio: Senior Strategic Advisor. Prospective contractors must demonstrate that they meet the qualifications listed in the Contract Announcement linked below, including, but not limited to being a former Medicaid Director who has recently left his/her position. This will be an 18-month contract with NAMD, starting on or around March 1, 2019. It can be performed from any location and is not based in Washington, DC.
As the description of contract services to be performed illustrates, this position offers a unique opportunity for a former Medicaid Director to continue to make meaningful and positive contributions to this critical health care program. The contractor will:
1. Work one-on-one with interested Medicaid Directors and their senior teams to provide strategic guidance and support, including to assist in designing, implementing and/or addressing barriers to a state-specific strategic plan and/or communication strategy;
2. Engage, coach and orient new Medicaid Directors (defined as in the position for less than a year) to an increasingly complex, politicized and sophisticated health care program;
3. Inform and guide NAMD’s programming with insights and information gathered from the above activities; and
4. Advise NAMD in other identified tasks and duties associated with the broader leadership development portfolio.
The full Contract Announcement and Description of Services can be found here.
The Contract Expression of Interest form – which is due to NAMD no later than Friday, December 28, 2018 – can be found here.
The State Expression of Interest form – for those states interested in receiving support from the contracted Senior Strategic Advisor – can be found here.
Senior Strategic Advisor Contract – SSA Contract FAQs
TennCare is Tennessee’s Medicaid program that provides health insurance coverage for 1.4 million low income children, pregnant women, disabled adults, and adult caretakers of children. TennCare currently covers one out of every five Tennesseans and 50% of all Tennessee births, with an annual budget of $11 billion. TennCare partners with its managed care organizations (MCOs) to provide high quality integrated physical, behavioral, and long term care to its member.
The Quality Oversight Assistant Division Director will be a key member and leader on the Medical Office Team reporting directly to the Chief Quality Officer.
Click here for full job description.
- Manage South Carolina Medicaid’s coverage policy by providing clinical expertise and leadership for the Coverage & Benefit Design and Pharmacy Groups.
- Provide leadership to assigned teams, maintaining an effective organization and fostering a performance-driven climate to drive the execution of the Division’s operational objectives.
- Represent the clinical interests and policy positions of the Department before internal and external stakeholders.
- Oversee the review of clinical case reviews for prior authorization and case management. Manage the activities of contract clinical staff to ensure timely and accurate adjudication of clinical reviews.
Full posing and application here.
The Texas Health and Human Services Commission (HHSC) Medicaid CHIP Services (MCS) department seeks a highly qualified candidate to fill the position of Chief Medical Director (CMD). The CMD is a key leadership position that has the opportunity to impact population health and quality of care provided to over four million Texans.
This role is responsible for driving the development and implementation of clinical strategies designed to address key public health issues, strengthening oversight of the clinical practices in a managed care environment, establishing policies that ensure care is provided in the most appropriate setting, and providing input on strategies regarding value based purchasing and alternative payment models.
The ideal candidate will have a strong clinical background, experience driving strategic initiatives that improve patient outcomes and population health, demonstrated leadership experience, and a solid grasp of nationally significant and emerging clinical issues.
The CMD directs the Office of the Medical Director, comprised of over 190 staff who are involved in clinical and operational activities. This includes responsibilities in the oversight of clinical guidelines, procedures, standards, and controls for the Texas Medicaid and CHIP programs.
This position also leads engagement with Medicaid’s Managed Care Medical Directors, and works closely on clinical issues across leadership in the health and human services system. They develop relationships and linkages with clinicians in child welfare, public health, behavioral health and other areas in the health system. The role is also required to develop relationships with key stakeholders including professional provider associations.
The individual in this position must be an expert collaborator adept at maintaining and fostering relationships with internal staff, managed care organizations, providers, professional organizations, other agencies, constituency groups, academic leaders and contractors, within a dynamic and structured environment.
Qualifications and Education
Graduation from an accredited college of medicine with a degree as a medical or osteopathic doctor. Completed residency training and/or practice requirements as above for board certification. Must be licensed as a Medical Doctor by the State of Texas.
Posting Title: Medicaid and CHIP Services Department, Chief Medical Director
Posting Number: 398857
Salary Range: $13,639.67 to $23,068.08
APPLY ONLINE AT: https://jobshrportal.hhsc.state.tx.us/ENG/careerportal/default.cfm
Are you looking to apply your leadership skills and financial expertise in the service of others? Do you enjoy collaboration, change management, and managing diverse, mission-oriented teams? The Virginia Medicaid program is seeking a dynamic Chief Financial Officer to serve on its Executive Management Team and help lead the Medicaid agency during a time of exciting transformation and opportunity. Virginia Medicaid provides essential health coverage to over 1.3 million Virginians and comprises nearly one-quarter of the state budget. The Chief Financial Officer is responsible for all finance, accounting, budget, and contracting functions of the $10 billion Medicaid agency. In addition, the position oversees provider reimbursement and value-based payment initiatives for the Medicaid program, leading key financial payment policy decisions for the largest health care payor in Virginia. This position reports directly to the Agency Director.
See full posting and apply here.
The Department of Health Care Services (DHCS) is looking for a highly skilled, exceptionally motivated individual to serve as the Senior Advisor for Health Care Programs. If you are interested in working with a team who is dedicated to preserving and improving the overall health and well-being of all Californians, this Department and job opportunity are for you.
Under the general direction of the Chief Deputy Director of Health Care Programs, the incumbent is responsible for ensuring the coordination of departmental programs and advising the Directorate on matters of policy critical to the Administration’s development of publicly financed health care programs, particularly Medi-Cal, and health care quality and improvement, particularly in the areas of health care financing, system transformation, behavioral health integration, and whole person care.
The Senior Advisor serves as a key part of the Chief Deputy Director’s team, will advise the Directorate on a variety of issues, and will act as a representative of the Chief Deputy Director, both within the Department and within external parties.
NOTE: Please also see JC-128988. This position may be filled at the CEA B level.