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State Jobs

State Jobs

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

May 19 - 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 18 - Massachusetts - Medicaid Chief Operating Officer

MassHealth is seeking a mission-driven, experienced, and passionate executive leader with operational and strategic expertise to fill the role of Chief Operating Officer.

The MassHealth Chief Operating Officer (COO) reports directly to the Medicaid Director and manages MassHealth’s Operations unit, which provides vital functions in support of the programs and services offered by MassHealth. The COO 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 MassHealth Operations unit consists of a number of high-impact departments, including Eligibility and Member Services, Provider and Claims Operations, Systems Operations, Publications, and Board of Hearings. These departments are responsible for critical aspects of the MassHealth program including member eligibility and enrollment, customer service, provider enrollment and credentialing, claims processing, and business oversight of the agency’s eligibility and claims systems. Together the MassHealth Operations team represents over half of the agency’s total employees and advances MassHealth’s mission by helping to deliver a seamless, streamlined, and accessible experience for members and providers.

The COO is responsible for both the day-to-day activities and functionality of the Operations unit, in addition to supporting MassHealth’s key priorities and important new initiatives. Over the coming months, MassHealth will be redetermining eligibility for the entire caseload of 2.2 million members for the first time in more than two years as the federal Public Health Emergency comes to an end. The COO will spearhead this mission critical work, which will include a large-scale outreach and communications campaign, operational and systems updates and readiness reviews, hiring and training of new staff and vendors to manage increased volume, collaboration with internal and external stakeholders, and continuous monitoring and enhancements throughout the redetermination process. In addition, the Operations unit will be managing MassHealth’s transition to a new customer service call center vendor, as well as continuing to work with other EOHHS agencies on streamlining and integrating application processes for various health and human services programs.

Full posting and application here.

March 10, 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 11, 2022 – Kansas – Medicaid Medical Director

Position Summary:  

The position (K0221812): This position is housed within KDHE’s Division of Health Care Finance (DHCF), which oversees the state’s medical assistance programs, including Medicaid (KanCare) and the Children’s Health Insurance Program (CHIP). The Medicaid Medical Director supervises the Clinical and Pharmaceutical teams within DHCF. The position reports to the State Medicaid Director.

The Medicaid Medical Director is responsible for identifying ways to improve health outcomes for beneficiaries, for example, by identifying inefficiencies in current benefit coverage; 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.

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.

Performs other oversight activities as assigned by Medicaid Director, DHCF Division Director, or the KDHE Secretary. Assists in responding to requests for information from legislators, other state agencies, and stakeholders.

Collaborates with other agencies (e.g. Public Health, KDADS) to identify opportunities to improve healthcare access, health outcomes, and efficiencies in the Kansas 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 KanCare management team to analyze current operations.

Job Responsibilities may include but are not limited to the following:

Collaboration with Partners: Builds and maintains working relationships with stakeholders, including providers, advisory councils and advocates. Networks with stakeholders and acts as a liaison between KanCare and the public. Assists in provider relations as necessary.

Full posting and application here.

February 10, 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 3, 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 21, 2022 – Wisconsin – Director of Programs and Policies

The Director of Bureau of Programs and Policy (BPP) is responsible for managing a team of 45 staff and supervisors and overseeing the development of the BadgerCare Health Maintenance Organization (HMO) contracts, Family Care Managed Care Organization (MCO) contracts, Partnership HMO contracts, and multiple Include, Respect, I Self-Direct (IRIS) contracts. The programs this position oversees impact the lives of over one million Wisconsinites and over six billion in annual expenditures.

This position is also responsible for directing, coordinating, planning, monitoring and evaluating the operational activities of all Sections and administrative support staff and the functions required to ensure development of the various managed care contracts, comply with both federal and state policies, and oversee other various procurement activities. In addition, this position is responsible for stakeholder engagement and the development of the managed care quality plan.

Full posting and application here.

January 18, 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 14, 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 31, 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.

June 22, 2021 - Washington - Medicaid Director

The Health Care Authority is now hiring for a Medicaid Director.

The Health Care Authority is looking for a proven leader who is well versed in Medicaid Services. The ideal candidate will be collaborative, with experience working in complex public or private healthcare organizations. They will have a proven track record of managing a diverse workforce that delivers services to a complex client base and will be able to look ahead strategically to envision the agency’s role in the future. The Medicaid Director will need to be an excellent communicator, skilled in change management, and able to use their ability to lead to energize staff and accomplish the agency’s mission and goals. If this role matches well with your talents and skill set, this may be the opportunity for you!

The Medicaid Director position will be open continuously $123,780.00 – $185,000.00 Annually

Stay Informed

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