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State Jobs

State Jobs

NAMD collects and updates job opportunities in Medicaid offices across all U.S. states and territories.

September 2022 - California - Pharmacy Benefits Division Chief

California’s Medicaid Program (Medi-Cal) is hiring a leader for Pharmacy Benefits

The salary range is: $133,224 – $158,712 per year.

Are you a mission-driven and exceptionally motivated person who wants to make a difference in the lives of Californians? Would you like to join an organization providing Californians access to affordable, integrated, high-quality, equitable health care?

DHCS seeks a new Pharmacy Benefits Division Chief for Medi-Cal, the largest Medicaid Program in the nation serving nearly 15 million or one in three Californians.

The successful applicant will set statewide policy for Medi-Cal Pharmacy Benefits, lead a team of 114 professionals, and be responsible for administering Medi-Cal Rx with internal and external partners. The Pharmacy Benefits Division also oversees drug rebate negotiations and programs and the Medi-Cal Vision Benefit. and Pharmacy Benefits are critical to members’ health and well-being.

Detailed information provided here.

September 2022 - Iowa - Management Analyst 3

Iowa Medicaid is hiring for a Management Analyst 3 position!

This position will be responsible for managing the court ordered consent decree at Glenwood Resource Center (GRC) and develop plans to improve quality and data tracking methodologies.

This position requires a high attention to detail and high motivation to drive actions forward. This position is based out of Des Moines, but will largely consist of remote work and on-site work.

To see the other qualifications for this position and see if you might be a good fit, visit: management-analyst-3 | Job Details tab | Career Pages (governmentjobs.com)

August 2022 - Alabama - Chief Medical Officer

The Alabama Medicaid Agency, Montgomery Central Office, seeks to fill a position of a Chief Medical Officer.

This position is responsible for providing clinical leadership and guidance to the Alabama Medicaid Agency in coordination with the Commissioner’s Office. This highly advanced professional, administrative, and medical position involves providing guidance in medical-related services within the Alabama Medicaid Agency. Work involves assisting agency officials in making determinations of level and quality of medical care provided to recipients by healthcare providers. Duties also include serving as medical consultant in the development and modification of healthcare policies and procedures, and the implementation of healthcare delivery systems statewide. Work is performed with a high degree of independent and professional judgment. This is a great opportunity for a Physician that wants to provide clinical guidance in an office setting.

Competitive Benefits and Salary:

• Desirable work schedule

• 40-hour work week (typically Monday – Friday 8 am to 5 pm)

• Health Insurance Coverage (Medical, Dental and Vision)

• Paid time off (including state holidays, annual and sick time)

If you are interested in this position, please call the Alabama Medicaid Agency at 334.242.5600 for more information by September 30, 2022.

August 2022 - New Hampshire - DIRECTOR-BUREAU DRUG AND ALCOHOL SERVICES

Director-Bureau Drug & Alcohol Services

Location: US:NH:CONCORD

Category: OTHER

Salary: 86,502.000-
120,562.000 USD

Post Date: 08/04/2022 Close Date: 09/20/2022

Description
State of New Hampshire Job Posting
Department of Health and Human Services
Bureau of Drug & Alcohol Services
Concord, NH

*See total compensation information at the bottom of announcement.
The State of New Hampshire, Department of Health and Human Services, Bureau of Drug and Alcohol Services has a full time
vacancy for Director.

SUMMARY:
Provides leadership and oversight of the Bureau of Alcohol and Drug Services’ program goals and objectives. Oversees
development and implementation of programs and policies to promote the prevention, treatment and recovery of individuals
experiencing substance use disorders. Acts as a leader on behalf of the Department by presenting information, education and
promotion of programs and policies at the State and National levels.

RESPONSIBILITIES:
Directs Bureau activities and staff responsible for program planning, implementation and evaluation; policy and systems
development and changes; and administrative, financial, business and personnel management.

Directs the implementation, integration, and coordination of all Bureau programs and activities, initiatives, and contracted
services, ensuring compliance with agency and federal requirements.

Requires proven leadership ability in planning and promoting the operations and goals of the Department’s substance use services,
including strong communication skills and the ability to work effectively with the media.

Provides subject matter expertise on substance use disorder and substance use services in various cross discipline initiatives.
Advises Division Director and Department leadership on substance use disorder and substance use services policy and programing.
Testifies before the state legislature, public and legislative hearings, and advisory and oversight committees to educate and
promote understanding of Bureau programs, goals, and mandates; affect public policy decisions; and provide information as
requested.

Serves as Executive Director of the Governor’s Commission on Alcohol and Other Drug Abuse Prevention, Intervention and
Treatment. Works with the Commission’s chair to set goals and objectives and works collaboratively with the membership to
ensure implementation of the goals and objectives, including oversight of the commission’s funding.

Serves on the DHHS Division of Behavioral Health Management Team to work collaboratively with other Team members in the
integration of behavioral health services as well as promoting the full continuum of care.

Participates in state, regional and national efforts to address substance use and misuse by NH residents.

MINIMUM QUALIFICATIONS:
Education: Master’s Degree with a major study in Social Work, Business or Public Administration, Master Licensed Alcohol and Drug
Counselor (MLADC), or a field directly related to health or social service programs.

Experience: Eight years’ experience in a public service, non-profit, health care or social service setting, four years of which should
be at a management level position involving the direction and administration of programs and staff.

LICENSE/CERTIFICATION: Valid driver’s license and/or access to transportation for use in statewide travel.
SPECIAL REQUIREMENTS: Occasional out of state travel for conferences and presentations, including weekends.

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.

For further information please contact Katja Fox, Director of DBH, Katja.S.Fox@DHHS.NH.GOV, 603-271-9406.

Documents that can’t be submitted online may be forwarded to:
Department of Health and Human Services- Human Resources
129 Pleasant Street
Concord, NH 03301

*TOTAL COMPENSATION INFORMATION
The State of NH total compensation package features an outstanding set of employee benefits, including:
HMO or POS Medical and Prescription Drug Benefits:
The actual value of State-paid health benefits is based on the employee’s union status, and employee per pay period health benefit
contributions will vary depending on the type of plan selected.
See this link for details on State-paid health benefits: https://das.nh.gov/hr/benefits.html

Value of State’s share of Employee’s Retirement: 14.53% of pay
Other Benefits:
o Dental Plan at minimal cost for employees and their families ($500-$1800 value)
o Flexible Spending healthcare and childcare reimbursement accounts
o State defined benefit retirement plan and Deferred Compensation 457(b) plan
o Work/life balance flexible schedules, paid holidays and generous leave plan
continued…
o $50,000 state-paid life insurance plus additional low cost group life insurance
o Incentive-based Wellness Program (ability to earn up to $500)
Total Compensation Statement Worksheet:
https://das.nh.gov/documents/hr/JobSearch/FINAL_TOTAL_COMP_STATEMENT_ISSUE.xlsx

Want the specifics? Explore the Benefits of State Employment on our website:
https://das.nh.gov/hr/documents/BenefitBrochure.pdf
https://das.nh.gov/hr/index.aspx

EOE
TDD Access: Relay NH 1-800-735-2964

August 2022 - Nebraska - Financial and Business Operations Administrator

Salary See Position Description

Location Lincoln, NE

Job Type PERM FULL TIME

Department Health & Human Services Department

Job Number 25371025

Closing Continuous

Description

The State of Nebraska, Department of Health and Human Services is seeking a full-time Financial and Business Operations Administrator for the Division of Medicaid and Long Term Care.

What we can offer you:

• Stable Employment Opportunity

• Career Development and Learning

• Tuition Reimbursement up to 100%

• 156% match of first 4.8% contribution to Retirement Plan

• 13 Paid Holidays

• Generous Leave Accruals and benefits

• Opportunity to be part of a caring organization• Flexible schedules

Job location is the Nebraska State Office Building, Downtown

Starting pay rate $33.922/hour, increase to $35.619/hour after successful completion of original probation period.

Examples of Work

This position is critical in the day to day operations of the Medicaid Finance Unit. This position oversees the Medicaid rates and reimbursement unit responsible for maintaining and updating provider reimbursement rates and implementing and executing alternative payment arrangements. This position also oversees the Medicaid Drug Rebate Accounting team responsible for collecting more than $125 Million in drug rebates annually to offset Medicaid Drug expenditures. The position also manages a team responsible for assisting with tracking Medicaid Aid and Admin Expenditures, preparing fiscal impacts for proposed state plan amendments, regulations, and program changes, as well as preparing fiscal notes and providing financial support on division projects, such as technology implementations. Last – this position is responsible for managing several contracts, most notably the Medicaid actuarial contract responsible for Managed Care capitation rate setting.

Qualifications / Requirements

REQUIREMENTS:  Bachelor’s Degree in public administration, social work, human development, public health, behavioral science, law, finance, human resources or other program related field AND four years of experience in a field related to the assigned program area including supervisory experience; OR a Master’s degree in any of the above mentioned fields and two years commensurate experience. Equivalent experience or coursework/training may be substituted for the educational requirement on a year-for-year basis.

PREFERRED:  5-10 years of healthcare finance experience. 3 years of Medicaid or similar experience or knowledge. 3 years of mid-high level leadership experience. Advanced Microsoft Excel and Database skills. Experience writing complicated queries. Experience creating financial models.

Knowledge, Skills and Abilities

Must be a team player and others centered; must be able to manage multiple high visibility/high risk tasks/projects; must be able to communicate professionally and effectively with many internal and external stakeholders including Medicaid providers; must be a quick learner and have demonstrated experience researching and problem solving complex issues.

DHHS State of Nebraska values our employees as well as a supportive environment that strives to promote Diversity, Inclusion, and Belonging. We recruit, hire, train, and promote in all job qualifications and at all levels without regard to race, color, religion, sex, age, national origin, disability, marital status, sexual orientation, or genetics.

For more information about the Nebraska Department of Health and Human Services and the Division of Medicaid and Long Term Care, please visit our website, http://dhhs.ne.gov

August 2022 - Massachusetts - Chief of Payment and Care Delivery Innovation

Summary:

MassHealth is seeking a mission-driven, experienced, and passionate executive leader with strategic and operational expertise to fill the role of Chief of Payment and Care Delivery Innovation (PCDI).

MassHealth is Massachusetts’ Medicaid and Children’s Health Insurance Program. MassHealth provides comprehensive health care coverage to more than 2 million residents of the Commonwealth, including 40% of all Massachusetts children and 60% of all residents with disabilities. MassHealth’s mission is to improve the health outcomes of our diverse members and their families by providing access to integrated health care services that sustainably and equitably promote health, well-being, independence, and quality of life. MassHealth operates as part of the Massachusetts Executive Office of Health and Human Services (EOHHS) and partners closely with other EOHHS agencies. It is led by the Assistant Secretary for MassHealth (Medicaid Director).

The Chief of PCDI reports directly to the Medicaid Director and manages MassHealth’s Office of PCDI, which is responsible for major MassHealth accountable and managed care programs. The Chief of PCDI plays a leadership role in setting the agency’s strategy for delivery system reform and payment innovation. The Chief of PCDI is also an integral member of MassHealth’s Executive Team and participates in the strategic planning, direction, coordination, and implementation of the agency’s programs, policies, and procedures.

The Office of PCDI oversees the MassHealth managed care programs for over one million members , including MassHealth Accountable Care Organizations (ACOs) and Managed Care Organizations (MCOs). These programs include contracts with the state’s largest provider systems and health plans and represent several billion in annual healthcare spending. The Office of PCDI is responsible for the oversight (including compliance, operational support, and relationship management) and performance (including financial, clinical quality, and member experience) of these programs and contracts, as well robust integration of our health equity goals.

In addition, the Office of PCDI operates various other delivery system reform programs, including the innovative Community Partners (CPs) and Flexible Services programs, which focus on integrating physical health, behavioral health, long-term services and supports, and social supports for members with complex and multi-faceted health care needs in order to improve health equity. PCDI manages significant portions of MassHealth’s 1115 Waiver with CMS, which authorizes these programs, including managing relationships with federal partners, leading negotiations where necessary, and overseeing the evaluation and refinement of the programs over time.

PCDI’s programs have proven successful in their first few years – increasing primary care engagement, reducing avoidable hospital utilization and certain inpatient admissions, increasing clinical quality scores, and reducing risk-adjusted total cost of care. They represent cutting edge work to deliver efficient and high-quality care to Medicaid populations.

In addition to overseeing these programs, the Chief of PCDI plays a leading role in shaping the agency’s strategy on the future of these programs, the agency’s overall health equity strategy, and the 1115 Waiver extension.

Over the coming months, MassHealth will be re-contracting with its ACOs and CPs, and launching the next version of these programs under an anticipated 1115 Waiver extension. This work will require significant operational coordination within the agency, as well as determine the strategic direction of these programs in the coming years. The Chief of PCDI will lead this cross-functional effort, as well as manage the implementation of other new initiatives that are part of the 1115 Waiver extension.

Duties and Responsibilities (these duties are a general summary and not all inclusive):

Oversee MassHealth’s ACO and MCO programs to ensure their compliance, operational stability, and performance, including:

Building robust compliance processes, documentation, and reporting to ensure ACOs and MCOs are meeting their contractual obligations.

Setting and executing on a nimble, data-driven, structured plan of performance management that measures ACOs and MCOs across various domains of importance (cost, quality, health equity, etc.), identifies actionable opportunities, and acts on them.

Collaborating with operations and IT systems teams to support day-to-day operational needs, resolve issues as they arrive, and continuously improve the flexibility and resilience of the programs.
Managing MassHealth’s relationships with plan and provider leadership at the senior-most levels.

Oversee MassHealth’s other delivery system reform efforts under the 1115 Waiver, including Community Partners and Flexible Services, and continuously evaluate and iterate the design of these programs to best serve our members and achieve equity goals.

Collaborate and coordinate effectively with other teams within the agency to lead and support key strategic initiatives as part of or related to the 1115 Waiver, including MassHealth’s anticipated Health Equity Incentive program.

Collaboratively and professionally manage MassHealth’s relationships with federal partners related to the operation of 1115 Waiver programs.

Encourage and develop staff through timely feedback and coaching to foster individual professional growth and a collective and supportive team culture.

Develop and monitor operating budget to ensure effective and efficient use of funds and manage workforce planning to ensure adequate staffing levels.

Preferred Qualifications:

Experience with and knowledge of value-based care, integrated care, and/or accountable care models, ideally as they pertain to Medicaid in particular. The ideal candidate knows the national literature as well as local history of such models, has first-hand experience with their successes and challenges, and has an informed, articulate point of view about how MassHealth should best leverage them into the future.

Senior-level relationship management experience. The ideal candidate is comfortable managing relationships at the senior-most levels with large provider and plan partners on behalf of the agency, including a range of professional and communication skills and the ability to have difficult but collaborative conversations when necessary.

Executive- or senior leadership-level management experience, including team management (recruiting, retention, team-building and culture work, etc.), operational budget and vendor management, strategic project management of large cross-functional enterprises, and managing a portfolio of programs or contracts and their performance. The ideal candidate has managed large operating budgets and has built and led large teams in various capacities.

Ability to work effectively in a matrixed organization, analyze complex programs, and design workable solutions for all stakeholders. The ideal candidate is collaborative, humble, proactive, and solution-oriented.

Skilled in exercising a high degree of initiative, judgement, discretion, and decision making to achieve objectives.

Strong commitment to diversity, equity, and inclusion both in the workplace and in health care.

Capability in balancing immediate priorities and urgent needs with the imperative to think strategically and thoughtfully for long-term planning and goals.

Experience managing complex, high-profile initiatives.

Proven ability to build relationships across departments and across organizations.

Thorough, detail-oriented, self-starter with excellent written and oral communication skills.

About MassHealth:

MassHealth, the Commonwealth’s Medicaid program, provides health care benefits to certain low and medium-income Massachusetts residents.

The mission of MassHealth is to improve the health outcomes of our diverse members, their families and their communities by providing access to integrated health care services that sustainably promote health, well-being, independence and quality of life.

For more information about our agency and programs please visit: www.mass.gov/masshealth

TO APPLY:

Please upload both Resume and Cover Letter for this position when applying.

Pre-Offer Process:

A criminal and tax history background check will be completed on the recommended candidate as required by the regulations set forth by the Executive Office of Health and Human Services prior to the candidate being hired. For more information, please visit http://www.mass.gov/hhs/cori and click on “Information for Job Applicants.”

Education, licensure and certifications will be verified in accordance with the Human Resources Division’s Hiring Guidelines.

Education and license/certification information provided by the selected candidate(s) is subject to the Massachusetts Public Records Law and may be published on the Commonwealth’s website.

If you require assistance with the application/interview process and would like to request an ADA accommodation, please click on the link and complete the Reasonable Accommodation Online Request Form

For questions, please the contact the Office of Human Resources at 1-800-510-4122 and select option #2.

Qualifications

MINIMUM ENTRANCE REQUIREMENTS:
Applicants must have at least (A) seven (7) years of full-time or, equivalent part-time, professional, administrative, supervisory, or managerial experience in business administration, business management, public administration, public management, clinical administration or clinical management of which (B) at least four (4) years must have been in a managerial capacity.

Comprehensive Benefits

When you embark on a career with the Commonwealth, you are offered an outstanding suite of employee benefits that add to the overall value of your compensation package. We take pride in providing a work experience that supports you, your loved ones, and your future.

Want the specifics? Explore our Employee Benefits and Rewards!

Executive Order #595: As a condition of employment, successful applicants will be required to have received COVID-19 vaccination or an approved exemption as of their start date. Details relating to demonstrating compliance with this requirement will be provided to applicants selected for employment. Applicants who receive an offer of employment who can provide documentation that the vaccine is medically contraindicated or who object to vaccination due to a sincerely held religious belief may make a request for exemption.

An Equal Opportunity / Affirmative Action Employer. Females, minorities, veterans, and persons with disabilities are strongly encouraged to apply.

The Commonwealth is an Equal Opportunity Employer and does not discriminate on the basis of race, religion, color, sex, gender identity or expression, sexual orientation, age, disability, national origin, veteran status, or any other basis covered by appropriate law. Research suggests that qualified women, Black, Indigenous, and Persons of Color (BIPOC) may self-select out of opportunities if they don’t meet 100% of the job requirements. We encourage individuals who believe they have the skills necessary to thrive to apply for this role.

Official Title: Administrator X
Primary Location: United States-Massachusetts-Boston-1 Ashburton Place
Job: Administrative Services
Agency: Exec Office Of Health and Human Services
Schedule: Full-time
Shift: Day
Job Posting: Jul 19, 2022, 12:48:53 PM
Number of Openings: 1
Salary: 57,285.28 – 177,590.49 Yearly
If you have Diversity, Affirmative Action or Equal Employment Opportunity questions or need a Reasonable Accommodation, please contact Diversity Officer / ADA Coordinator: Johny Laine/Johny.Laine@mass.gov – 6177804719
Bargaining Unit: M99-Managers (EXE)
Confidential: No

July 2022 - Tennessee - Deputy Chief Financial Officer

POSITION ANNOUNCEMENT

Deputy Chief Financial Officer

State Classification: TennCare Deputy Director

TENNCARE OVERVIEW

TennCare is Tennessee’s managed care Medicaid program that provides health insurance coverage to certain groups of low-income individuals such as pregnant women, children, caretaker relatives of young children, older adults, and adults with physical disabilities. TennCare provides coverage for approximately
1.6 million Tennesseans and operates with an annual budget of approximately $14 billion. It is run by the Division of TennCare with oversight and some funding from the Centers for Medicare and Medicaid Services (CMS).

WHY WORK AT TENNCARE?

TennCare’s mission is to improve the lives of Tennesseans by providing high-quality cost-effective care. To fulfill that purpose, we equip each employee for active participation and empower teams to communicate and work collaboratively to improve organizational processes in order to make a difference in the lives our members. Because of the positive impact TennCare has on the lives of the most vulnerable Tennesseans, TennCare employees report that their work provides them with a sense of meaning, purpose, and accomplishment. TennCare leadership understands that employees are our most valuable resource and ensures professional and leadership development are a priority for the agency.

JOB AND DEPARTMENTAL OVERVIEW

The Deputy Chief Financial Officer is located within TennCare’s fiscal division and reports directly to the Chief Financial Officer. TennCare’s fiscal division is responsible for the strategic and day-to-day management of the agency’s $14 billion annual budget and fiscal processes, ensuring that cost-effective care is delivered in a way that is sustainable for the state budget. The Deputy Chief Financial Officer will have a team of financial and data analysts that serve as direct reports. This senior-level position will work closely with the CFO and other senior staff within fiscal and across the agency to manage and implement various fiscal projects and processes.

The Deputy Chief Financial Officer will:
• Assist the CFO and Director of Budget with formulating and tracking TennCare’s annual $14B budget;
• Manage a team of financial and data analysts to report and provide analysis on various financial key performance indicators;
• Manage the relationships with several key external vendors and stakeholders;
• Manage the development and implementation of annual nursing facility reimbursement rates totaling over $1B in annual spend;
• Contribute in meetings with actuaries involving the development of capitation rates that are paid to the state’s managed care organizations (MCOs); and
• Manage and implement various projects that have a fiscal focus

The successful candidate will have an ability to work both independently and collaboratively on highly visible projects from start to finish. Additionally, the successful candidate will be able to communicate effectively and professionally with a wide range of individuals – from stakeholders and advocates to senior
leaders in business and government.

Job duties may also include researching and reporting on various healthcare issues and policy; engaging with data by recognizing patterns and effectively communicating observations and results to others; and solving highly technical and complex problems in processes and other workflows.

MINIMUM QUALIFICATIONS:

• A master’s degree in business, finance, public administration, public health, public policy, or other related field from an accredited college or university
— AND —
5+ years of related work experience in budget, finance, health care, government, or other related areas
• Strong analytical skills, with a demonstrated ability to recognize patterns and trends in data and on how to ask and find answers to complex questions and problems.
• Demonstrated problem-solving skills with a track record in creating business processes and improving existing ones
• Strong computer skills including expert proficiency in Microsoft Office applications, especially Word and Excel
• Proficiency in oral and written communication skills, with a demonstrated ability for concise and effective communication
• Strong organizational skills, including the ability to prioritize, multi-task, and manage workload to meet specific timeframes and deadlines

DESIRED QUALIFICATIONS:
• Direct experience working for a state Medicaid agency or in a job function that specialized in Medicaid
• Demonstrated ability to effectively manage teams of direct reports

TO APPLY:

Applications are due by 8/10/2022. To apply, go to www.tn.gov/careers and search for job ID “34418.” If you have any questions, please reach out to Zane Seals at zane.seals@tn.gov.

Pursuant to the State of Tennessee’s Workplace Discrimination and Harassment policy, the State is firmly committed to the principle of fair and equal employment opportunities for its citizens and strives to protect the rights and opportunities of all people to seek, obtain, and hold employment without being subjected to illegal discrimination and harassment in the workplace. It is the State’s policy to provide an environment free of discrimination and harassment of an individual because of that person’s race, color, national origin, age (40 and over), sex, pregnancy, religion, creed, disability, veteran’s status or any other category protected by state and/or federal civil rights laws.

July 2022 - Wyoming - State Medicaid Agent

Open Until Filled

Salary
$8,815.73 – $11,018.80 Monthly

Location
Cheyenne, WY

Job Type
Full Time

Department
048-Div. of Healthcare Financing – Administration

Job Number
2022-03883

GENERAL DESCRIPTION:

The Wyoming Department of Health is looking for a strong leader to serve as its new State Medicaid Agent. The ideal candidate will have deep expertise in Medicaid or health insurance, demonstrate superior leadership and communication skills, and be driven by a compelling big-picture vision of Medicaid’s role in Wyoming’s health and human services sector.

The Department’s mission is to promote, protect, and enhance the health of all Wyoming residents. The department has four operating divisions – Behavioral Health, Aging, Public Health, and Healthcare Financing – and oversees five state-owned healthcare facilities.

The State Medicaid Agent oversees the Division of Healthcare Financing, which includes the Wyoming Medicaid and CHIP programs, and is responsible for providing medical and long-term care insurance to approximately 80,000 enrolled members.

This position has responsibility for all components of the division and provides executive leadership, overall direction, and strategic vision for Medicaid statewide. The position is based in Cheyenne, Wyoming, and reports to the Director of the Wyoming Department of Health with a formal appointment from the Governor of Wyoming.

Human Resource Contact: Anissa French wdhrecruit@wyo.gov

ESSENTIAL FUNCTIONS: The listed functions are illustrative only and are not intended to describe every function which may be performed at the job level.

Oversee all aspects of the Division of Healthcare Financing at the Wyoming Department of Health, including management of the Wyoming Medicaid and CHIP programs.

Lead personnel in all operating sections of the division
Ensure the smooth continued implementation of the WINGS project, which is Wyoming’s Integrated Next-Generation System – a redesigned and modularized replacement to Wyoming’s Medicaid Management Information System (MMIS)

Drive strategic planning and performance management for the division

Manage the division’s budget of approximately $1,500,000,000
Participate in the department’s senior leadership team
Streamline cross-divisional, and intradepartmental Medicaid processes to ensure seamless operations for high-priority and shared clients

Qualifications

PREFERENCES:

Preference will be given to candidates with at least ten years of experience in healthcare administration (preferably in Medicaid programs), public administration, or a related field.

KNOWLEDGE:

Healthcare administration
Public administration
Budget development and management
Legislative processes

MINIMUM QUALIFICATIONS:

None – See “Preferences”

Necessary Special Requirements

PHYSICAL WORKING CONDITIONS:

Typically, the employee will sit comfortably to perform the work, however, there may be some walking, standing, bending, and carrying light items

NOTES:

FLSA: Exempt
The Wyoming Department of Health is an E-Verify employer.
Supplemental Information

048-Wyoming Department of Health – Division of Healthcare Financing

Click here to view the State of Wyoming Classification and Pay Structure.

URL: http://agency.governmentjobs.com/wyoming/default.cfm

The State of Wyoming is an Equal Opportunity Employer and actively supports the ADA and reasonably accommodates qualified applicants with disabilities.

Class Specifications are subject to change, please refer to the A & I HRD Website to ensure that you have the most recent version.

Agency
State of Wyoming

Address
See Human Resource Contact Information
in the General Description Section
Statewide, Wyoming, 82002

Website
http://agency.governmentjobs.com/wyoming/default.cfm

July 2022 - Nevada - Medicaid Medical Division / Sr. Physician

MEDICAID MEDICAL DIRECTOR/SR. PHYSICIAN

Division of Health Care Financing and Policy

Salary: up to $176,943 (Employee/Employer Paid Retirement Schedule)

The Nevada Division of Health Care Financing and Policy (DHCFP) is seeking to fill the position of Medicaid Medical Director. This is a full-time (40 hours per week) permanent unclassified position and will be housed in either Northern Nevada (Carson City or Reno) or Clark County (Las Vegas), depending on the location of the most qualified candidate. Statewide travel will be required.

The mission of DHCFP is to purchase and provide quality health care services to low-income Nevadans in the most efficient manner; promote equal access to health care at an affordable cost to the taxpayers of Nevada; restrain the growth of health care costs; and review Medicaid and other state health care programs to maximize potential federal revenue.

THE POSITION: This position is within the Division of Health Care Financing and Policy, commonly known as Nevada Medicaid. The Medicaid Medical Director supervises the Medical and Pharmaceutical teams within DHCFP. This position reports directly to and serves at the pleasure of the Administrator of DHCFP.

The Medicaid Medical Director is responsible for identifying ways to improve health outcomes for beneficiaries, for example, by identifying inefficiencies in current benefit coverage and addressing health disparities among beneficiaries; recommending policy changes to better align state medical assistance programs with evidence-based best practices; and recommending actions to improve quality and access to care for beneficiaries, with an emphasis on maternal and infant health and primary care services. Policy development and other oversight: Manages policy development activities of clinical and pharmaceutical teams. Manages oversight of managed care entity utilization management decisions, review processes and quality performance. Works with managed care organizations to address clinical policy issues and assists DHCFP team as needed with supporting provider capacity to engage in value-based payment and delivery models in the Medicaid program. Performs other oversight activities as assigned by the Administrator. Assists in responding to requests for information from legislators, other state agencies, and stakeholders. Collaborates with other Department of Health and Human Services agencies to identify opportunities to improve healthcare access, health equity, health outcomes, and efficiencies in the Nevada Medicaid delivery system. Quality improvement: Participates and oversees program reviews through identification and analysis of medical information to develop interventions and policies to improve quality of care and health outcomes. Promote quality improvement by working with management team to analyze current operations. Participate in the federally mandated hearings program and assist with defending actions taken by Nevada Medicaid at Administrative Law Hearings. This includes, but is not limited to: attending internal and external meetings, Fair Hearings, and Hearing Preparation Meetings for both recipients and providers; providing a detailed explanation of the basis for actions taken by Nevada Medicaid, to include the clinical rationale when the action is related to medical necessity; Page 2 of 2performing additional clinical reviews upon request for hearing related matters, providing expert witness testimony at hearings (in person, telephone and videoconference) that is consistent with the action taken by Nevada Medicaid; modifying or adjusting actions taken in accordance with decisions issued by the Hearing Officer.

Participate in independent professional reviews of providers to determine the quality of care, compliance with patient rights, and appropriateness of placement as assigned. Provide guidance to Health Care Coordinator RN staff in reviewing physician progress notes and medical records to ensure the requested service, treatment, equipment or supplies are medically necessary and in compliance with Medicaid criteria.

QUALIFICATIONS: Medical Doctor or Doctor of Osteopathy (M. D. or D. O. degree) and current, unrestricted license to practice medicine in the State of Nevada, or ability to obtain a license to practice in the State of Nevada are required. Minimum of five years of successful clinical practice experience. Health plan or capitated provider experience is preferred, but not required with exposure to: utilization management, quality management, peer review, case management, denial/appeals, disease management, HEDIS reporting, and provider relations. This position requires domestic travel (up to 50%, location dependent).

An ideal candidate is someone who has interest in population health and the link between social determinants of health (SDH) and clinical outcomes; is an effective communicator; and is capable of analyzing and synthesizing relevant information and presenting in a concise and policy-relevant manner.

BENEFITS: Medical, dental, vision care, life and disability insurance program; paid holidays; generous leave benefits and contribution to the secure defined-benefit retirement plan (NV PERS). State employees do not contribute to Social Security. Long-term employees enjoy additional benefits. For additional information, please visit the Nevada Division of Human Resource Management at http://hr.nv.gov/, the Nevada Public Employees Benefits at http://pebp.state.nv.us/, and the Public Employees Retirement System of Nevada at http://nvpers.org/.

SPECIAL NOTES: Fingerprinting and a background investigation through the FBI and DPS are required. The employee is responsible for all background check fees upon hiring, plus additional fees for rolling fingerprints.

TO APPLY: Please submit your Curriculum Vitae which details your experience, responsibilities, the nature and size of the organization/programs you worked for, salary history, reasons for leaving prior employment, and professional references to: Logan Kuhlman

Division of Health Care Financing and Policy1100 E William St, Suite 101, Carson City, Nevada 89701Ph: (775) 684-3688; Fax: (775) 684-3893Lkuhlman@dhcfp.nv.gov

SELECTION PROCESS: Application material will be screened based on the qualifications; those candidates deemed most qualified will be invited to interview. Announcement will remain open until recruitment needs are satisfied.

June 2022 - Louisiana - Program Monitor-DHH

Salary
$4,044.00 – $7,958.00 Monthly

Location
Baton Rouge, LA

Job Type
Classified

Department
LDH-Office of Secretary

Job Number
OS/DRT/157925

Closing
6/28/2022 11:59 PM Central

This position is located within the Louisiana Department of Health / Office of the Secretary / Undersecretary / East Baton Rouge

Announcement Number: OS/DRT/157925
Cost Center: 3071170104
Position Number(s): 50636816 and 50636817

This vacancy is being announced as a Classified position and may be filled as a Job appointment, Probationary or Promotional appointment.

No Civil Service test score is required in order to be considered for this vacancy.

Program Monitor positions are located in the Policy and Quality Improvement section in the Office of the Secretary.

Job Duties includes:

Research national and state policy trends and initiatives for consideration by LDH leadership regarding LDH program areas. Sources of research may vary such as gatherings of state officials, requests to/from federal funding agencies from other states, peers, blogs, posts to federal/state/industry websites, foundation websites/publications and trade magazines.
Support the development and oversight of LDH Business Plans and Business Plan Outcomes Reports and the quality improvement initiatives contained within, including drafting and editing internal reports for Department leadership over the course of the year.
Work closely with assigned LDH program office(s) and designated program office quality coordinators to:
Understand how policy changes can be quantified and measured across various agencies within LDH;
Assist with the development of qualitative and quantitative performance metrics and related monitoring tools for the programs within LDH for internal and external consumption and decision making;
Ensure the coordination of data gathering and quality metric reporting across the various program offices within LDH to benchmark, measure, and report on state health performance and improvements;
Coordinate the development, processing and implementation of federal, state, and LDH policy initiatives. Bring forward any issues, needs, or concerns for assigned agencies; and
Assist in drafting and finalization of policies, manuals, information bulletins and memorandum for assigned program offices assuring compliance with requirements.
Design, develop, and prepare reports and relevant statistics and process for quality improvement projects.
Assist with and perform activities to ensure effective review for accuracy and comprehensiveness of documents involved in the policy development and publication process.
Coordinate work with policy and rulemaking sections to ensure LDH operational framework supports the achievement of goals and performance targets in existing and proposed policies. Work with those sections to identify any changes necessary to operation framework, ensure implementation and measurement of said changes.
Lead Department Data Governance Committee, and develop and maintain Data Governance Charter
Prepare and validate data reports produce reports for external use/dissemination
Develop and maintain tracking tools to ensure timely implementation of LDH and legislative policy initiatives.
Develop and maintain data monitoring frequency, extraction tools, dictionary, repository and reporting formats.
Assist with developing, implementing and maintaining training materials to address LDH data management, quality metric, diagrams, inputs and outputs, business processes, project plan development, monitoring and reporting policies developed by the unit.
Assist Supervisor and Policy Director with the formulation and implementation of current and long-term plans, policies and procedures to facilitate and enhance LDH’s program objectives.

To apply for this vacancy, click on the “Apply” link above and complete an electronic application, which can be used for this vacancy as well as future job opportunities. Applicants are responsible for checking the status of their application to determine where they are in the recruitment process. Further status message information is located under the Information section of the Current Job Opportunities page.

*Resumes WILL NOT be accepted in lieu of completed education and experience sections on your application. Applications may be rejected if incomplete.*

A resume upload will NOT populate your information into your application. Work experience left off your electronic application or only included in an attached resume is not eligible to receive credit

For further information about this vacancy contact:

Deanda Thymes
Deanda.Thymes@la.gov
LDH/HUMAN RESOURCES
BATON ROUGE, LA 70821
225 342-6477

This organization participates in E-verify, and for more information on E-verify, please contact DHS at 1-888-464-4218.

Qualifications

MINIMUM QUALIFICATIONS:
A baccalaureate degree plus two years of professional level experience in administrative services, economics, public health, public relations, social services, health services, or surveying and/or assessing health or social service programs or facilities for compliance with state and federal regulations.

SUBSTITUTIONS:
Six years of full-time work experience in any field may be substituted for the required baccalaureate degree.

Candidates without a baccalaureate degree may combine work experience and college credit to substitute for the baccalaureate degree as follows:

A maximum of 120 semester hours may be combined with experience to substitute for the baccalaureate degree.

30 to 59 semester hours credit will substitute for one year of experience towards the baccalaureate degree.
60 to 89 semester hours credit will substitute for two years of experience towards the baccalaureate degree.
90 to 119 semester hours credit will substitute for three years of experience towards the baccalaureate degree.
120 or more semester hours credit will substitute for four years of experience towards the baccalaureate degree.

College credit earned without obtaining a baccalaureate degree may be substituted for a maximum of four years full-time work experience towards the baccalaureate degree. Candidates with 120 or more semester hours of credit, but without a degree, must also have at least two years of full-time work experience to substitute for the baccalaureate degree.

Graduate training with eighteen semester hours in one or any combination of the following fields will substitute for a maximum of one year of the required experience on the basis of thirty semester hours for one year of experience: public health; counseling; social work; psychology; rehabilitation services; statistics; experimental/applied statistics; economics; business, public, or health administration.

A Juris Doctorate will substitute for one year of the required experience.

A master’s degree in public health; counseling; social work; psychology; rehabilitation services; economics; business, public, or health administration will substitute for one year of the required experience.

Graduate training with less than a Ph.D. will substitute for a maximum of one year of the required experience.

A Ph.D. in public health; counseling; social work; psychology; rehabilitation services; economics; business, public, or health administration will substitute for the two years of required experience.

NOTES:
Health services include all services dealing with the diagnosis and treatment of disease, or the promotion, maintenance and restoration of health for sick or injured individuals.

Public health includes jobs such as sanitarian, public health engineer and public health epidemiologist.

NOTE:
Any college hours or degree must be from a school accredited by one of the following regional accrediting bodies: the Middle States Commission on Higher Education; the New England Commission of Higher Education; the Higher Learning Commission; the Northwest Commission on Colleges and Universities; the Southern Association of Colleges and Schools; and the Western Association of Schools and Colleges.

Job Concepts

Function of Work:
To perform research, analysis and policy management activities related to statewide health or social service program(s).

Level of Work:
Advanced.

Supervision Received:
Broad from a Program Monitor Supervisor–DHH or higher level.

Supervision Exercised:
None.

Location of Work:
Department of Health and Hospitals; Human Service Districts as established; and other social service entities as established by an approved DSCS Allocation Criteria Memorandum.

Job Distinctions:
Differs from Program Monitor Supervisor–DHH by the absence of supervisory responsibility.

Differs from Program Manager 1-A–DHH and Program Manager 1-B–DHH by the absence of responsibility for administering small or less complex statewide program(s).

Examples of Work
Assist with coordination, management and monitoring of statewide program(s).

Plans and coordinates the monitoring and reporting process for statewide program(s).

Develops and implements policy procedures for statewide program(s).

Monitors contracts for adherence to deliverables. Monitors service providers for compliance with federal/state guidelines and financial solvency.

Writes, negotiates and processes programmatic and budgetary contracts; initiates and negotiates contracts for new clinic agencies.

Assists with the writing and managing of grant funds.

May provide functional supervision to regional employees.

Analyzes data to track training and technical assistance needs. May conduct or coordinate training for agency staff.

Presents information to community partners and to relevant agencies.

Prepares and reviews reports from facilities and other programs outlining statistical analysis and trends.

Serve on various committees for the purpose of formulating of policies and quality assurance methods.

Assesses regional needs related to resources, information gaps and barriers to service.

Implements provider recruitment strategies to address resource and service needs.

Assists rural and underserved communities in their efforts to secure grant funding for community-based projects to improve access to local health care services by way of: skill-building, training, grant writing, technical assistance, etc.

Monitors expenditures and accounts payable for grant and contract deliverables.

Tracks occurrences and participates in investigations.

Coordinates and maintains department’s internal monitoring procedures for legislation.

Coordinates with Information Technology staff for the design and maintenance of data reports.

Apply Here

June 2022 - Louisiana - Program Monitor-DHH

Salary
$4,044.00 – $7,958.00 Monthly

Location
Baton Rouge, LA

Job Type
Classified

Department
LDH-Office of Secretary

Job Number
OS/DRT/157933

Closing
6/19/2022 11:59 PM Central

This position is located within the Louisiana Department of Health / Office of the Secretary / Undersecretary / East Baton Rouge

Announcement Number: OS/DRT/157933
Cost Center: 3071170104
Position Number(s): 50636814 and 50636815

This vacancy is being announced as a Classified position and may be filled as a Job appointment, Probationary or Promotional appointment.

No Civil Service test score is required in order to be considered for this vacancy.

Program Monitor positions are located in the Policy and Quality Improvement section in the Office of the Secretary.

Job Duties includes:

Research national and state policy trends and initiatives for consideration by LDH leadership regarding LDH program areas. Sources of research may vary such as gatherings of state officials, requests to/from federal funding agencies from other states, peers, blogs, posts to federal/state/industry websites, foundation websites/publications and trade magazines.
Support the development and oversight of LDH Business Plans and Business Plan Outcomes Reports and the quality improvement initiatives contained within, including drafting and editing internal reports for Department leadership over the course of the year.
Work closely with assigned LDH program office(s) and designated program office quality coordinators to:
Understand how policy changes can be quantified and measured across various agencies within LDH;
Assist with the development of qualitative and quantitative performance metrics and related monitoring tools for the programs within LDH for internal and external consumption and decision making;
Ensure the coordination of data gathering and quality metric reporting across the various program offices within LDH to benchmark, measure, and report on state health performance and improvements;
Coordinate the development, processing and implementation of federal, state, and LDH policy initiatives. Bring forward any issues, needs, or concerns for assigned agencies; and
Assist in drafting and finalization of policies, manuals, information bulletins and memorandum for assigned program offices assuring compliance with requirements.
Design, develop, and prepare reports and relevant statistics and process for quality improvement projects.
Assist with and perform activities to ensure effective review for accuracy and comprehensiveness of documents involved in the policy development and publication process.
Coordinate work with policy and rulemaking sections to ensure LDH operational framework supports the achievement of goals and performance targets in existing and proposed policies. Work with those sections to identify any changes necessary to operation framework, ensure implementation and measurement of said changes.
Lead Department Data Governance Committee, and develop and maintain Data Governance Charter
Prepare and validate data reports produce reports for external use/dissemination
Develop and maintain tracking tools to ensure timely implementation of LDH and legislative policy initiatives.
Develop and maintain data monitoring frequency, extraction tools, dictionary, repository and reporting formats.
Assist with developing, implementing and maintaining training materials to address LDH data management, quality metric, diagrams, inputs and outputs, business processes, project plan development, monitoring and reporting policies developed by the unit.
Assist Supervisor and Policy Director with the formulation and implementation of current and long-term plans, policies and procedures to facilitate and enhance LDH’s program objectives.
To apply for this vacancy, click on the “Apply” link above and complete an electronic application, which can be used for this vacancy as well as future job opportunities. Applicants are responsible for checking the status of their application to determine where they are in the recruitment process. Further status message information is located under the Information section of the Current Job Opportunities page.

*Resumes WILL NOT be accepted in lieu of completed education and experience sections on your application. Applications may be rejected if incomplete.*

A resume upload will NOT populate your information into your application. Work experience left off your electronic application or only included in an attached resume is not eligible to receive credit

For further information about this vacancy contact:
Deanda Thymes
Deanda.Thymes@la.gov
LDH/HUMAN RESOURCES
BATON ROUGE, LA 70821
225 342-6477

This organization participates in E-verify, and for more information on E-verify, please contact DHS at 1-888-464-4218.

Qualifications

MINIMUM QUALIFICATIONS:
A baccalaureate degree plus two years of professional level experience in administrative services, economics, public health, public relations, social services, health services, or surveying and/or assessing health or social service programs or facilities for compliance with state and federal regulations.

SUBSTITUTIONS:
Six years of full-time work experience in any field may be substituted for the required baccalaureate degree.

Candidates without a baccalaureate degree may combine work experience and college credit to substitute for the baccalaureate degree as follows:

A maximum of 120 semester hours may be combined with experience to substitute for the baccalaureate degree.

30 to 59 semester hours credit will substitute for one year of experience towards the baccalaureate degree.
60 to 89 semester hours credit will substitute for two years of experience towards the baccalaureate degree.
90 to 119 semester hours credit will substitute for three years of experience towards the baccalaureate degree.
120 or more semester hours credit will substitute for four years of experience towards the baccalaureate degree.

College credit earned without obtaining a baccalaureate degree may be substituted for a maximum of four years full-time work experience towards the baccalaureate degree. Candidates with 120 or more semester hours of credit, but without a degree, must also have at least two years of full-time work experience to substitute for the baccalaureate degree.

Graduate training with eighteen semester hours in one or any combination of the following fields will substitute for a maximum of one year of the required experience on the basis of thirty semester hours for one year of experience: public health; counseling; social work; psychology; rehabilitation services; statistics; experimental/applied statistics; economics; business, public, or health administration.

A Juris Doctorate will substitute for one year of the required experience.

A master’s degree in public health; counseling; social work; psychology; rehabilitation services; economics; business, public, or health administration will substitute for one year of the required experience.

Graduate training with less than a Ph.D. will substitute for a maximum of one year of the required experience.

A Ph.D. in public health; counseling; social work; psychology; rehabilitation services; economics; business, public, or health administration will substitute for the two years of required experience.

NOTES:
Health services include all services dealing with the diagnosis and treatment of disease, or the promotion, maintenance and restoration of health for sick or injured individuals.

Public health includes jobs such as sanitarian, public health engineer and public health epidemiologist.

NOTE:
Any college hours or degree must be from a school accredited by one of the following regional accrediting bodies: the Middle States Commission on Higher Education; the New England Commission of Higher Education; the Higher Learning Commission; the Northwest Commission on Colleges and Universities; the Southern Association of Colleges and Schools; and the Western Association of Schools and Colleges.

Job Concepts

Function of Work:
To perform research, analysis and policy management activities related to statewide health or social service program(s).

Level of Work:
Advanced.

Supervision Received:
Broad from a Program Monitor Supervisor–DHH or higher level.

Supervision Exercised:
None.

Location of Work:
Department of Health and Hospitals; Human Service Districts as established; and other social service entities as established by an approved DSCS Allocation Criteria Memorandum.

Job Distinctions:
Differs from Program Monitor Supervisor–DHH by the absence of supervisory responsibility.

Differs from Program Manager 1-A–DHH and Program Manager 1-B–DHH by the absence of responsibility for administering small or less complex statewide program(s).

Examples of Work
Assist with coordination, management and monitoring of statewide program(s).

Plans and coordinates the monitoring and reporting process for statewide program(s).

Develops and implements policy procedures for statewide program(s).

Monitors contracts for adherence to deliverables. Monitors service providers for compliance with federal/state guidelines and financial solvency.

Writes, negotiates and processes programmatic and budgetary contracts; initiates and negotiates contracts for new clinic agencies.

Assists with the writing and managing of grant funds.

May provide functional supervision to regional employees.

Analyzes data to track training and technical assistance needs. May conduct or coordinate training for agency staff.

Presents information to community partners and to relevant agencies.

Prepares and reviews reports from facilities and other programs outlining statistical analysis and trends.

Serve on various committees for the purpose of formulating of policies and quality assurance methods.

Assesses regional needs related to resources, information gaps and barriers to service.

Implements provider recruitment strategies to address resource and service needs.

Assists rural and underserved communities in their efforts to secure grant funding for community-based projects to improve access to local health care services by way of: skill-building, training, grant writing, technical assistance, etc.

Monitors expenditures and accounts payable for grant and contract deliverables.

Tracks occurrences and participates in investigations.

Coordinates and maintains department’s internal monitoring procedures for legislation.

Coordinates with Information Technology staff for the design and maintenance of data reports.

Apply Here

June 2022 - Vermont - Medicaid Director

Application Deadline Date:  07/05/2022

Req ID:  34421

Department:  Human Services Agency

Location:  Waterbury, VT, US

Position Type:  Exempt

Schedule Type:  Full Time

Hourly Rate:  Commensurate with experience.

How to Apply

*Do not apply online*. Please send application materials directly to Sarah Truckle at sarah.truckle@vermont.gov.

Overview

The Vermont Agency of Human Services is seeking qualified candidates for the State Medicaid Director position to oversee the Vermont Medicaid program.  Vermont Medicaid is administered through several departments within the Agency of Human Services: the Department of Health Access serves as the State’s Medicaid managed care entity; the Department of Health oversees programs for alcohol and substance use disorders and for children with special health needs; the Department of Mental Health and Department of Disabilities, Aging, and Independent Living oversee Vermont’s Home and Community-Based Services; and the Department for Children and Families administers Medicaid-funded programs for individuals in foster care, receiving targeted case management, and early invention services. The Department of Corrections is also housed in the Agency of Human Services and strong coordination of services in and out of facilities is a priority of the Medicaid program.

Description

This position will set and lead strategic priorities for Vermont Medicaid.  This will require close coordination and partnership with the departments within the Agency of Human Services.

The principal duties of the position include:

•    Directing strategic initiatives such as improving managed care oversight; sister state agency partnership and restructuring; advancing population health and strategies to improve social factors that contribute to health; and promoting health equity, diversity and inclusion.

•    Engaging a wide range of stakeholders including executive branch leadership, the legislature, provider groups and trade associations on topics such as significant program initiatives, budget and policy expectations, and enforcement of Medicaid requirements and federal/state mandates across departments.

•    Ensuring effective staff management, including oversight of Medicaid activities and priorities across departments.

•    Directing and evaluating programs and services, including budget and finance alignment, working with federal partners, overseeing activities associated with general operations and compliance, and empowering teams to work outside functional siloes and maintain active relationships across the organization to contribute to larger agency goals.

•    Oversee the Agency’s $1.7B Medicaid budget crossing all six departments.

•    Set and lead strategic priorities for Vermont Medicaid in addition to serving as the Agency’s primary point of contact with the CMS.

The ideal candidate has strong business acumen and political savvy and is skilled at:

•    Developing, directing, and delegating others

•    Leadership and personnel management

•    Leading innovation and strategic planning

•    Developing vision and purpose

•    Communicating vision internally and externally

•    Communicating effectively to internal and external audiences

•    Managing conflict and negotiating key issues

•    Leading innovation and managing change

•    Technical learning (understanding complex Medicaid rules/systems)

Compensation

Compensation for this position is commensurate with experience.

Equal Opportunity Statement

The State of Vermont celebrates diversity, and is committed to providing an environment of mutual respect and meaningful inclusion that represents a variety of backgrounds, perspectives, and skills. The State does not discriminate in employment on the basis of race, color, religion or belief, national, social or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, membership in an employee organization, family medical history or genetic information, or family or parental status. The State’s employment decisions are merit-based. Retaliatory adverse employment actions by the State are forbidden.

Apply now »

May 2022 - Tennessee - Chief of Long-Term Services and Supports

HOW TO APPLY: To apply, please visit https://www.tn.gov/careers/apply-here/external-candidate.html.

JOB AND DEPARTMENTAL OVERVIEW

The TennCare Chief of Long-Term Services and Supports (LTSS) leads the LTSS program strategy and department, which is a team of highly capable staff who are committed to leading the ongoing development and operation of an innovative, sustainable, person-driven LTSS system in which older adults and people with disabilities and/or chronic conditions have choice, control and access to a full array of high quality services and supports that assure optimal outcomes, including independence, health and quality of life.

LTSS includes approximately 75 staff, subdivided into 5 teams: an Operations team that leads and directs LTSS medical eligibility determination, program enrollment/disenrollment and appeals processes and systems, including the LTSS Help Desk; Policy, Programs, Contracts and Compliance that is responsible for policy, contracting and compliance monitoring for nearly 40 LTSS contracts; Data Governance and Reporting that manages all aspects of LTSS data, reporting and auditing; a forward-facing Quality, Accountability and Innovation that encompasses quality assurance and performance improvement, value-based purchasing and delivery system transformation; and an Executive Supports team that leads project management, HR liaison and employee relations, communication, and associated support functions across LTSS.

RESPONSIBILITIES

  • Lead all aspects of TennCare LTSS and Dual Eligible programs and operations, including strategy and innovation; policy and program design, implementation, and improvement; contracts; eligibility and enrollment; budget and legislative processes; federal waivers and compliance monitoring; and partner/stakeholder relationships.
  • Serve as a member of TennCare’s executive team, collaborating with other business areas to accomplish the overall mission and vision of the agency.
  • Envision and execute strategic initiatives to accomplish goals aligned with TennCare’s strategic plan, including the integration of programs and services for individuals with intellectual and developmental disabilities under the managed care program.
  • Strengthen interagency and other external partnerships, establishing a model for Medicaid and I/DD agency collaboration in aligning programs to create a single, person-centered system of service delivery for individuals with I/DD.
  • Partner with physical and behavioral health leadership to develop and enhance the continuum of care for individuals served in LTSS.
  • Coordinate with Quality and Policy Divisions to oversee LTSS components of TennCare III Shared Savings measures, Quality Strategy, and Evaluation Design.
  • Lead federal funding initiatives to strengthen LTSS programs and services including American Rescue Plan Enhanced HCBS FMAP Spending Plan and Money Follows the Person Rebalancing Demonstration.
  • Envision and execute LTSS value-based purchasing and delivery system transformation initiatives.
  • Lead workforce development strategies to increase the capacity, competency, and consistency of the LTSS frontline workforce.
  • Oversee and evolve the LTSS organizational structure, including recruitment, engagement, training, growth, and development.
  • Provide thought leadership to impact federal policy and support other states.
  • Implement new LTSS eligibility/enrollment replacement system (PERLSS).

QUALIFICATIONS

  • Bachelor’s degree in a related field; Master’s Degree preferred.
  • A minimum of 5 years’ experience in Medicaid, with experience in LTSS and managed care highly preferred.
  • Strengths in strategy, vision and innovation.
  • Respectful, trustworthy, and empathetic; communicates thoughtfully and works with integrity across groups and settings, especially in high pressure situations.
  • High-level decision-making abilities.
  • Strong organizational and critical thinking skills; adaptability to meet changing needs and demands.
  • Ability to identify, analyze and address a wide variety of issues and problems in a high-intensity environment.
  • Knowledge of the goals, objectives, structure and operations of Medicaid, including LTSS.
  • Ability to perform complex tasks and to prioritize and oversee multiple projects.
  • Superior research, writing, and oral communication.
  • Ability to create, compose, and edit correspondence and other written materials adapted to the unique audience.
  • Skill in examining and re-engineering programs, operations, and procedures, formulating policy, and developing and implementing new strategies and procedures.
  • Exceptional interpersonal skills and the ability to interact and work effectively with a wide array of stakeholders.

JOB LOCATION:  Nashville, Tennessee

March 2022 – Florida – Assistant Deputy Secretary for Medicaid Finance and Analytics

This is an exciting opportunity to help shape the quality of health care in Florida. The Agency is seeking to hire an Assistant Deputy Secretary for Medicaid Finance and Analytics who desires to work to enhance the delivery of health care services through the Florida Medicaid program.  This position requires a candidate who is creative, flexible, innovative, and who will thrive in a fast-paced, team-based work environment.

This position is located in the Division of Medicaid and is one of three Assistant Deputy Secretaries reporting to the Deputy Secretary for Medicaid.  This position has full line authority with respect to the Bureaus of Medicaid Program Finance and Medicaid Data Analytics. Duties of this position include, but are not limited to:

  • Establishing goals, objectives and priorities for Medicaid that are consistent with Agency goals and mission.
  • Directing the development of comprehensive Medicaid strategic and program plans that will efficiently and effectively carry out Agency goals and objectives.
  • Participate in the development and implementation of uniform policies and administrative rules for Medicaid Program Finance and Medicaid Data Analytics.
  • Direct the development of procedures and guidelines with respect to Medicaid Program Finance and Medicaid Data Analytics.
  • Plan for and review procurement documents and contracts within the areas of responsibility, ensuring appropriate coordination with the Centers for Medicare and Medicaid Services (CMS) and other parties.
  • Direct the planning, preparation, presentation, and monitoring of the $38B Medicaid budget to ensure consistency with Agency goals, objectives and priorities, and the most efficient and effective use of local, state, and federal resources. Review and approve Medicaid program spending plans, corrective action plans, and proposed budget amendments.
  • Represent the Agency before the Legislature and other governmental and non-governmental entities. This includes representing the Deputy Secretary for Medicaid in meetings or conferences where authority to make decisions on behalf of the Agency may be required.
  • Communicate with, motivate, train, and evaluate employees, and plan and direct employees’ work. Employee has the authority to hire, transfer, suspend, lay off, recall, promote, discharge, assign, reward, and discipline subordinate employees or effectively recommend such action, including employees serving as supervisors, administrators, and directors.

Full posting and application here.

February 2022 – Washington – Medicaid Finance Manager

The Medicaid Finance Manager plays a critical role in managing the financial resources entrusted to HCA by ensuring federal funds are secured and being claimed appropriately. Additionally, this position is tasked with being the subject matter expert pertaining to the Medicaid Management Information Systems (MMIS) APDs, and identifying opportunities to realize additional federal funds, which are used to fund existing IT projects and procurements as well as funding new ones within HCA and with external partners.

This position provides advanced-level technical analysis, advice, and recommendations to management decision makers, including the HCA Chief Financial Officer and agency executive management. The incumbent’s work directly affects the management of the HCA Medicaid budget which is the largest source of federal funding in the State of Washington totaling over $10 billion annually and representing over 70% of the state’s federal revenue. This position is responsible for developing complex financial models, projections, and strategies to ensure sound financial management and operations of Medicaid IT projects. This work includes fiscal impact analysis and requires detailed knowledge and understanding of multiple program areas from the business, legislative, regulatory, budget, and technical perspectives.

This position is eligible to telework part time but is frequently required to report on-site to meet business needs.

Full posting and application here.

February 2022 – Iowa – Medicaid Program Manager-Medical Services

The Iowa Medicaid Enterprise (IME) division of the Department of Human Services (DHS) is seeking a knowledgeable and creative Medicaid Program Manager to join the team. Be part of an organization that is continually working to modernize and innovate solutions to improve the quality of life and health outcomes for the state’s Medicaid members.

The (IME) is an endeavor that unites State Staff and “Best of Breed” contractors into a performance-based model for the administration of the Iowa Medicaid program. Medicaid is a state-federal funded program that is administered by the Department of Human Services of the State of Iowa and is the second largest insurance program in the State of Iowa.  The IME establishes the state’s policy to oversee performance and compliance of the Medicaid Managed Care program.

This position requires strong knowledge of Medicaid policies and is responsible for the administration of the Medicaid programs.  Continual analysis of coverage and reimbursement policies are conducted to assess current and pending federal requirements.  Looking at future programmatic changes and options to meet federal and state program goals is a critical component of this job. Identifying, managing and capturing performance data to conduct performance analysis of Managed Care Organizations (MCO) and vendors is another important aspect of the job duties.

Full posting and application here.

January 2022 - South Carolina - Deputy Director for Finance and Chief Financial Officer

This position is located in the Office of Finance and Administration, Richland County. The incumbent serves as the Chief Financial Officer (CFO) for the South Carolina Department of Health and Human Services (SCDHHS).

The CFO oversees the agency’s financial activities including forecasting and monitoring of the operating budget, accurate and timely payment disbursement, financial reporting, and decision support analytics. The incumbent oversees provider reimbursement policies and negotiates complex multi-million dollar agreements including managed care contracts.

The incumbent is heavily involved in strategic planning for SCDHHS and acts as a critical partner to the Department’s Director and leadership team. The CFO oversees the agency’s decision support function, providing agency-wide reporting, analytics, and financial forecasting for current programs, while also modeling the potential impact of anticipated changes due to statutory or regulatory changes, newly-proposed initiatives, or other market forces.

Full posting and application here.

January 2022 - Iowa - Supplemental Payment Regulatory Advisor

This Supplemental Payment Regulatory Advisor provides the legal foundation needed to support the Medicaid Supplemental Payment program including intergovernmental transfers associated with the supplemental payment process. This Regulatory Advisor provides expertise regarding legal documents that underlie complex business structures; mergers and acquisitions, and complex business, accounting, and financial transactions that intersect with Medicaid regulations and healthcare. The Supplemental Payment Regulatory Advisor has detailed understanding of Medicare and Medicaid regulation and associated Iowa statute and rules. This individual stays abreast of the changes in the field, including the ability to research and understand both state and federal legislative and regulatory changes; federal guidance; and administrative body and court decisions.

The Supplemental Payment Regulatory Advisor: • Researches laws, legal opinions, policies, regulations, legal texts, and precedent cases to provide legal advice related to the Supplemental Payment Program. • Examines formal filings for legal sufficiency and full disclosure required by statutes, rules, and regulations. • Reviews legal documentation of Supplemental Payment Program participants to ensure compliance with federal and state regulations and program compliance. • Assesses documentation and materials associated with intergovernmental transfer processes to ensure compliance with state and federal law. • Drafts letters, memos, opinions, legislative reports, and other legal materials. • Drafts and comments on contracts and agreements associated with the supplemental payment program. • Maintains legal documentation associated with the program. • Comments on and/or drafts proposed legislation or changes in agency regulations. • Coordinates with the Attorney General’s Office to represent and defend Medicaid’s interests associated with the Supplemental Payment Program.

Full posting and application here.

November 2021 - Rhode Island - Medicaid Program Director

GENERAL STATEMENT OF DUTIES: Within the Executive Office of Health and Human Services, to perform leadership and executive duties in the planning, coordinating, implementing and directing the Rhode Island Medicaid Program; to collaborate with other State agencies to ensure all publicly financed health care services are integrated and coordinated; and to do related work as required. SUPERVISION RECEIVED: Works under the general supervision of the Secretary and Deputy Secretaries with wide latitude for the exercise of initiative and independent judgment; work is subject to conformance with policy, state and federal law, rules and regulations. SUPERVISION EXERCISED: Plans, supervises, directs, coordinates and reviews the work of departmental personnel and provides coordinating oversight, on behalf of the Secretary, of the work related to the program.Full posting and application here.

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