Staff Manager

2 weeks ago


Santa Fe, New Mexico, United States State of New Mexico Full time
Job Summary

We are seeking a highly skilled Staff Manager to join our team at the State of New Mexico. This role will provide direct oversight and monitoring of Medicaid Managed Care Organization (MCO) contracts, ensuring compliance and effective management of healthcare services.

Key Responsibilities
  • Lead and direct oversight and monitoring activities of MCOs
  • Provide ongoing feedback and identify trends in contract oversight activities
  • Participate in site visits, readiness reviews, and evaluations of MCOs as requested
  • Cultivate productive work relationships with MCO clinical and administrative staff to achieve contract goals and objectives
  • Serve as a resource for healthcare assistance, providing information to consumers, consumer advocates, providers, and the general public regarding the Medicaid managed care program
  • Collaborate with MCO clinical staff to facilitate resolution of member issues as needed
  • Triage consumer and provider calls based on judgment
  • Assist the provider community in their interactions with MCOs and the Medicaid managed care delivery system
  • Evaluate the urgency of health situations and direct consumers or providers to the most appropriate healthcare resource for resolution
  • Participate in the enhancement or revision of contract amendments, policy manuals, and the development of regulatory language as needed
Requirements
  • Experience with Medicaid programs and contracts
  • Experience working at high-level contract management and oversight
  • Experience implementing program policies and procedures
  • Experience providing technical assistance and training
  • Experience working with social service programs or community outreach organizations
Preferred Qualifications
  • Bachelor's degree in any field of study from an accredited college or university and five (5) years of professional-level experience operating within parameters and guidelines directly related to the purpose of the position defined by the agency at the time of recruitment
Working Conditions

Work is performed in an office setting with exposure to Visual/Video Display Terminal (VDT) and extensive personal computer and phone usage.

Agency Contact Information

Jolene Jaffa, Email


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