Medicaid Director

19 hours ago


Rockville, Maryland, United States Health eCareers Full time
Job Summary

As a key leader of the Medicaid national line of business, the Executive Director of Medicaid, Maryland is responsible for leading, managing, and coordinating KP's Medicaid strategy, planning, regulatory relationships, health plan operations, member service, compliance, industry relationships, and related activities in Maryland.

This role involves close coordination with a variety of KP regional, national, and shared service leaders and functions that support Medicaid operations and the services provided to beneficiaries in Maryland and for all KP regions.

Key Responsibilities
  • Lead, manage, and coordinate strategy, planning, health plan operations, compliance, regulatory, and industry relationships, and related activities in Maryland.
  • Work closely with all national, shared service, and MAS market leaders and other care delivery and medical group leaders to support MAS with implementation of the strategy, regulatory, and operational requirements.
  • Lead, manage, mentor, and develop Medicaid leaders and staff in Maryland and across the KP program to provide subject matter expertise to support the market and shared services with implementation of Medicaid regulatory requirements.
  • Maintain a deep understanding of current and potential state and Federal Medicaid, CHIP, and related legislation and regulations, and their impact on KP Medicaid strategy, operations, and performance.
  • Monitor and maintain a deep understanding of the national, Maryland health plan, and provider competitive environment as it relates to Medicaid, dual eligibles, and vulnerable populations.
Requirements
  • Minimum ten (10) years of professional experience in the health insurance business or in a consulting role focused on projects supporting Medicaid, Medicare, and other government-sponsored programs or care delivery systems supporting low-income and vulnerable populations.
  • BA in business or related area required.
  • Extensive knowledge and expertise in Medicaid and CHIP.
  • Demonstrated experience and success in health plan and/or care delivery operations and business development in Medicaid Managed Care.
  • Prior healthcare leadership experience for five or more years, including Medicaid and other State Sponsored programs.

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