Supplemental Information

Job #:MVA/KDC/1206

This position is located within the LA. Department of Health/MVA/Eligibility/Orleans Parish

Cost Center: 305-8311

Position #’s:50301049, 50593153, 50593216, 50593217, 50593223, 50593255, 72838, 176030, 60384, 50470962

This vacancy is being announced as a classified position and may be filled as Probational, Promotional or a Job Appointment.

(Job Appointments are temporary appointments that may last up to 48 months)

Applicants must have Civil Service test scores for 8100-Professional Level Exam in order to be considered for this vacancy unless exempted by Civil Service rule or policy. If you do not have a score prior to applying to this posting, it may result in your application not being considered.

Applicants withoutcurrent test scores can apply to take the test here.

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.*

For further information about this vacancy contact:

Kelsi Chaney

LDH/Human Resources

P.O. Box 4818, Baton Rouge, LA 70821

Kelsi.Chaney@la.gov Qualifications

MINIMUM QUALIFICATIONS:

A baccalaureate degree.

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 willsubstitute 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 tosubstitute for the baccalaureate degree.

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 Association of Schools and Colleges; 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.

NOTE:

An applicant may be required to possess a valid Louisiana driver’s license at time of appointment. Job Concepts

FUNCTION OF WORK:

To make initial and continuing determination, under close supervision, as to clients’ eligibility for all Medicaid programs.

LEVEL OF WORK:

Entry.

SUPERVISION RECEIVED:

Medicaid Analysts typically report to a Medicaid Analyst Supervisor. May receive supervision from higher level personnel.

SUPERVISION EXERCISED:

None.

LOCATION OF WORK:

Department of Health and Hospitals, Medical Vendor Administration.

JOB DISTINCTIONS:

Differs from Medicaid Analyst 2 by the presence of close supervision and the absence of independent action.

Examples of Work

EXAMPLES BELOW ARE A BRIEF SAMPLE OF COMMON DUTIES ASSOCIATED WITH THIS JOB TITLE. NOT ALL POSSIBLE TASKS ARE INCLUDED.

Under close supervision, the entry level Medicaid Analyst learns to perform the following duties:

Conducts interviews with clients and makes other necessary collateral contacts for verification in determining eligibility for Medicaid Programs.

Examines application packets for timeliness, completeness, and appropriateness prior to authorization of reimbursement.

Makes decisions on complex eligibility factors and determines level of benefits for federal and state funded programs as a result of the rolldown procedure.

Interprets and applies complex federal, state, and agency policies for each program.

Conducts special investigations and compiles reports concerning fraud and location of absent parents.

Counsels and refers potentially eligible recipients or applicants to other agencies.

Contacts individuals, companies, businesses, local, state and federal agencies as needed to obtain or to verify information.

Records findings, recommendations, and services provided; completes case record forms and necessary correspondence in connection with assigned cases.

 
 

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The Jacobson Group Saint Louis, MO

Job Description

Job Responsibilities – The auditor will uncover issues with the way the system is linking the providers fee schedules. The auditor would look at the claims for any alterations (i.e. Modifiers billed but not keyed, denials applied to the claim in error resulting in an underpayment, incorrect data entry not corrected before finalizing resulting in overpayments etc.) This position is not looking at coding or editing. Just reading and applying the policy against the examiners’ action that altered the payment and whether it was supported by the policy and whether the fee schedule on the provider file is interfacing accurately with the claim.

Handling IL and MI Medicaid: Working on MCS. The goal will be to audit up to 30 claims per day when they are trained. The project is set to go until a minimum of January 2022.
 

Skill Set /Experience Requirements–
1.    Seasoned claims experience either in auditing, configuration, testing or other claims specialties
2.    Previous experience with audit or system checking of some level
3.    Problem Solver and Critical Thinker
 

Company Description

The Jacobson Group is the leading provider of insurance talent. For 50 years, we have been connecting insurance organizations with professionals from the board room to the back room on both a permanent and temporary basis. We offer a variety of solutions including executive search, professional recruiting, RPO, temporary staffing, subject matter experts, and onsite and work-at-home operations support. Regardless of the need or situation, Jacobson is the insurance talent solution.

The Jacobson Group

Why Work Here? This company is very reputable and have a great pay structure. On top of the salary, there is an opportunity to make 15K+ is bonuses as well

The Jacobson Group is the leading provider of insurance talent. For 50 years, we have been connecting insurance organizations with professionals from the board room to the back room on both a permanent and temporary basis. We offer a variety of solutions including executive search, professional recruiting, RPO, temporary staffing, subject matter experts, and onsite and work-at-home operations support. Regardless of the need or situation, Jacobson is the insurance talent solution.

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Position:  Senior Provider Contracting Professional – Behavioral Health/Medicaid
*Description
* The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Senior Provider Contracting Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors..
* Responsibilities
* .
* Assignment:
* Humana Behavioral Health.
*

Location:

* SC The Senior Provider Contracting Professional for SC Medicaid communicates contract terms, payment structures, and reimbursement rates to providers. Providing a comprehensive hospital network to consumers in the behavioral health arena and executing on Humana’s consumer-focused business strategy demands constant negotiation with a variety of provider constituencies and continual re-prioritization of corporate and consumer needs. Analyzes financial impact of contracts and terms.

Maintains contracts and documentation within a tracking system. May assist with identifying and recruiting providers based on network composition and needs. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. In this role you will:

+ Negotiate hospital and ancillary contracts at market competitive pricing. + Initiate and maintain productive long-term relationships with key hospital and group practice administrators and members. + Communicate proactively with other departments in order to ensure effective and efficient business results. +

You will handle services and levels of care and pricing on the behavioral health network side + Subject matter expert on their assigned region or states on all things behavioral health networks + Manage large accounts and/or provider relations + Associate management oversight of 3-5 direct reports + C-suite interactions both internally and externally.
* Role Essentials
* + 3-4 years of progressive network management experience including hospital contracting and network administration in a healthcare company or healthcare system + Medicaid behavioral health contracting experience + Medicaid provider relations experience (face to face provider visits required + Experienced in negotiating managed care contracts with large physician groups, ancillary providers and hospital systems. + Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures and reimbursement rates to providers.

+ Excellent written and verbal communication skills +

Ability to manage multiple priorities in a fast-paced environment + Proficiency in MS Office applications + Previous leadership experience and oversight of Associates +

Ability to have difficult conversations with individuals at all levels of the organization internally and externally +

Ability to manage regional accounts +

Ability to adapt well when utilizing multiple new systems + Strong negotiation skills.
* Role Desirables
* + Behavioral health contracting experience + Bachelor’s Degree +

Experience with ACO/Risk Contracting +

Experience with Value Based Contracting.
* Additional Information
* This position is “remote/work at home”, however, you must live within the state of South Carolina in order to be considered for this opportunity. Humana is an organization with careers that change lives-including yours. As an innovator in the fast-paced industry of healthcare, we offer our associates careers that challenge, support and inspire them to use their passion for helping others and to lead their best lives.

If you’re ready to help people achieve lifelong well-being, and be a part of an organization that is growing and poised to make an impact on the future of healthcare, Humana has the right opportunity for you..
* Scheduled Weekly Hours
* 40

 
 

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NaphCare has an excellent opportunity for a Medicaid Reimbursement Specialist to join our Corporate Headquarters in Birmingham, AL.

The Medicaid Reimbursement Specialist will research and interpret regulatory payment policies and claims processing guidelines for multiple Medicaid states.

The ideal candidate will have a strong knowledge and previous experience of CPT, ICD-10, HCPCS, Code Modifiers as assigned by the Centers for Medicare and Medicaid Services (CMS).

NaphCare partners with correctional facilities to provide proactive, patient-focused healthcare.

We recognize that we serve a unique and diverse patient population, and our onsite teams take pride in bringing excellence in care to a population in great need.

Be part of a world-class team of professionals who are revolutionizing correctional healthcare.

Responsibilities:Perform data analysis tasks, which include extracting fee schedules, provider files, base rates and edits using software programs such as Microsoft Excel.

Assist in maintaining fee schedules and data in all systems.

Liaison with third party pricing and editing vendors (i.e.

3M, Payer Compass, Optum).

Educating internal staff regarding payment systems and procedures.Analyze claims pre and post processing to ensure Medicaid rates and edits are applied accurately.

Assist in reviewing provider appeals to determine if claims paid accurately.

Requirements:Bachelor’s degree or equivalent combination of education and applicable job experience.

Minimum of three years of experience with Medicaid billing, claims processing and reimbursement.

Experience with multiple Medicaid states and provider types (i.e.

hospital, professional, ambulance, DME, clinical lab, etc.) preferred.Experience with working in claims payment systems; with multiple pricing and editing software (i.e.

3M, Payer Compass, Optum programs, etc.) preferred.Experience with Medicare billing and reimbursement; both Part A and Part B a plus.

CPC certification a plus.This is not a remote position.Equal Opportunity Employer: disability/veteranOutstanding Benefits Package:NaphCare offers competitive benefits, including health, prescription, dental, Employment Assistance Program (EAP) services, vision and 401(k).

NaphCare offers term life insurance at no cost to the employee and provides PTO, paid holidays and an array of voluntary benefits.

Employees enrolled in our health insurance program receive prescriptions free of charge when filled at our in-house pharmacy or mail order program.

 
 

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Requisition No: 384501

Agency: Agency for Health Care Administration

Working Title: 68064319 – MEDICAL/HEALTH CARE PROG ANALYST

Position Number: 68064319

Salary: $1,574.93 – $1.613.39 / Bi-Weekly

Posting Closing Date: 06/09/2021

This is an exciting opportunity to help shape the quality of health care in Florida. The Agency for Health Care Administration (AHCA) is the State of Florida agency responsible for oversight of the Medicaid program. The Medicaid program provides low-income families and individuals with access to health care. If you have a desire to use your talent and skills at an organization that provides critical services to millions of individuals and families across the state, AHCA invites you to apply to become an essential member of our team. As one of Florida’s leading state agencies, AHCA’s diverse workforce community of more than 1,400 employees is proud of its efforts to serve the people of Florida.

We are seeking to hire a Medical/Health Care Program Analyst 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 Bureau of Medicaid Quality. Medicaid Quality provides data-driven, focused and systematic feedback on the quality of Florida’s Medicaid program to federal and state agencies, Medicaid recipients, Medicaid managed care plans, and providers. The Bureau of Medicaid Quality has a strong focus on providing more comprehensive care, improving health outcomes, and reducing costs.

This position is responsible for providing contract management of certain Medicaid contracts within the Bureau of Medicaid Quality, Quality Improvement & Evaluation Contracts Section. This position is involved in the research, development, procurement, and management of various contracts.

AHCA offers an excellent array of benefits, including:

• Health insurance
• Life insurance
• Dental, vision and supplemental insurance
• Retirement benefits
• Vacation and sick leave
• Paid holidays
• Opportunities for career advancement
• Tuition waiver for public college courses
• Training opportunities

For more information about the Bureau of Medicaid Quality, please visit our website at http://ahca.myflorida.com/Medicaid/index.shtml.

Join us at the Agency for Health Care Administration in fulfilling our mission to provide “Better Health Care for all Floridians.”

KNOWLEDGE, SKILLS, AND ABILITIES

• Knowledge and experience with Medicaid, other healthcare systems, or contract management.
• Skilled in writing contracts.
• Skilled in reviewing and analyzing data related to the delivery and execution of services.
• Skilled in the use of computer systems for general office purposes (e.g., Microsoft Office Suite and Internet Explorer).
• Ability to direct and coordinate the planning and implementation of operational and program reviews.
• Ability to formulate monitoring protocols and procedures in order to monitor effectively.
• Ability to provide valuable feedback based on monitoring discovery to Medicaid policy staff and program managers.
• Ability to utilize problem-solving techniques.
• Ability to understand and apply applicable rules, regulations, policies and procedures pertaining to a health services program.
• Ability to assess contract budgetary needs.
• Ability to plan, organize, prioritize, and coordinate various work activities.
• Ability to communicate effectively.
• Ability to establish and maintain positive and effective working relationships with others..
• Ability to travel with or without accommodations.

MINIMUM QUALIFICATION REQUIREMENTS

• Minimum of one year of experience managing a project, contract, or grant.
• Minimum of four years of professional experience in a health or rehabilitation program involving program or policy planning and development, program research or evaluation, finance, statistical analysis, accounting, auditing or budget analysis.

A bachelor’s degree from an accredited college or university in business, statistics, mathematics, economics, public administration, health or social services administration is preferred and can substitute for one year of the required experience.

LICENSURE, CERTIFICATION, OR REGISTRATION REQUIREMENTS

N/A

CONTACT: JESSICA DAY 850-412-4332

The State of Florida is an Equal Opportunity Employer/Affirmative Action Employer, and does not tolerate discrimination or violence in the workplace.

Candidates requiring a reasonable accommodation, as defined by the Americans with Disabilities Act, must notify the agency hiring authority and/or People First Service Center (1-866-663-4735). Notification to the hiring authority must be made in advance to allow sufficient time to provide the accommodation.

The State of Florida supports a Drug-Free workplace. All employees are subject to reasonable suspicion drug testing in accordance with Section 112.0455, F.S., Drug-Free Workplace Act.

VETERANS’ PREFERENCE. Pursuant to Chapter 295, Florida Statutes, candidates eligible for Veterans’ Preference will receive preference in employment for Career Service vacancies and are encouraged to apply. Candidates claiming Veterans’ Preference must attach supporting documentation with each submission that includes character of service (for example, DD Form 214 Member Copy #4) along with any other documentation as required by Rule 55A-7, Florida Administrative Code. Veterans’ Preference documentation requirements are available by clicking here. All documentation is due by the close of the vacancy announcement.

Nearest Major Market: Tallahassee

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Anthem, Inc.

Job Description

Description SHIFT: Day JobSCHEDULE: Full-timeYour Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care. This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America’s leading health care companies and a Fortune Top 50 Company. The is responsible for writing strategic, highly customized, complex proposal responses to win and retain existing business. Primary duties may include, but are not limited to: Develops written solutions incorporating complex, custom win strategies based on local market needs, leveraging best practices, brand standards, innovative ideas, and reviewer insights. Identifies and creates standard content for the proposal database and edits content as needed. Aligns multiple written communication efforts with the overall Anthem messaging and goals. Partners with Subject Matter Experts (SMEs) to transfer knowledge, develop new solutions, obtain direction and create alternative solutions. Researches, recommends and develops creative approaches and solutions to content. Serves as a key communications resource for business leaders and collaborates across various areas to support enterprise-wide selling initiatives. Qualifications Requires a BA/BS degree; 5 years of health care specific proposal writing experience; or any combination of education and experience, which would provide an equivalent background. Experience working in a heavily matrixed environment and proven relationship-building skills required. Expert level experience in managing large-scale proposals or communication initiatives including writing and reviewing healthcare bids for healthcare companies in a deadline-driven environment required. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

 
 

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Senior Finance Professional-KY Medicaid

• Job Reference: 287388799-2
• Date Posted: 19 May 2021
• Recruiter: Humana
• Location: Brentwood, Tennessee
• Salary: On Application
• Sector: Accounting
• Job Type: Permanent

Apply for this job now

Job Description

*Description* The Senior Market Finance Professional collects, analyzes and reports on various market data to connect financial outcomes with operational effectiveness. The Senior Market Finance Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors..*Responsibilities* The Senior Market Finance Professional works with Actuary, Corporate Finance, Clinical, Market Leadership, and Providers/Hospitals/Ancillary externally to drive optimization inclusive of activities spanning decisions required for day-to-day operations to strategic planning and addressing specific business performance issues across matrixed organization and fostering key relationships with business stakeholders. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments..*Required Qualifications* + Bachelor’s degree or equivalent experience + 3+ years of financial planning and analysis experience + Experience using SQL to extract and analyze data + Strong attention to detail + Ability to work independently and collaborate with teammates + Comprehensive working knowledge of all Microsoft Office applications, including Word, Access, and PowerPoint + Advanced Excel experience (Pivot Tables, Charts, Formulas… .) + Must be passionate about contributing to an organization focused on continuously improving consumer experiences + Eagerness to learn and innovate + Must have accessibility to high speed DSL or cable modem for a home office (satellite Internet service is NOT allowed for this role); and a minimum Internet connection speed of 10M x 1M.*Preferred Qualifications* + Masters of Business Administration (MBA) + Experience with PowerBI.*Scheduled Weekly Hours* 40

 
 

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Description

SHIFT: Day Job

SCHEDULE: Full-time

 

Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.

 
 

This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America’s leading health care companies and a Fortune Top 50 Company.

 
 

Actuarial Director (Medicaid Pricing)

 
 

Preferred Locations: Atlanta, GA; St. Louis, MO; Indianapolis, IN; Mason, OH; Waukesha, WI; Louisville, KY; Richmond, VA; Virginia Beach, VA; Tampa, FL

 
 

Will consider other locations for the most qualified applicant

 
 

The Actuarial Director identifies, evaluates and responds to financial risks inherent in the pricing and development of health insurance products. Position will support Medicaid pricing in multiple states.

 
 

Primary duties may include, but are not limited to:

 
 

• Prepares and interprets data and related formulae.

 
 

• Monitors trend of profit and profitability by line of business and/or product.

 
 

• Serves on major, multi-function projects as Actuarial representative.

 
 

• Organizes and directs the staffing and work flow of the section.

 
 

Qualifications

 
 

• Requires a BS/BA degree; FSA required from the Society of Actuaries (SOA) with at least 6 years of related experience, or ASA from the Society of Actuaries (SOA) with at least 9 years of related experience; or any combination of education and experience, which would provide an equivalent background.

 
 

• Medicaid pricing experience highly desired.

 
 

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

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Description

SHIFT: Day Job

SCHEDULE: Full-time

 

Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.

 
 

This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America’s leading health benefits companies and a Fortune Top 50 Company.

 
 

Given Anthem’s scale, balance sheet, broad national reach and depth at the local market level, Anthem has established a new business unit called the Diversified Business Group.  The Diversified Business Group is a solutions-oriented business unit within the Company that will support Anthem and other external clients in the pursuit of transforming healthcare.

 
 

DBG Client Development Dir

 
 

Location: This position will be remote. 

 
 

Responsible for the development of new client accounts. Potential clients include: health plans and health benefits administrators/TPAs, employer groups, benefit consultants, state and federal government entities (i.e. CMS, state Medicaid), healthcare providers and integrated delivery systems/accountable care organizations (ACO).

 
 

Primary duties may include, but are not limited to:

 
 

 
 

• Develops strategies and executes plans to identify, target, and secure new sales to achieve goals in growth, profitability, retention, and strategic value.

 
 

• Sells the DBG value proposition to Medicaid / Commercial and Specialty Business Division.

 
 

• Provides consultative subject matter expert information on the suite of products offered by DBG.

 
 

• Designs and implements standard and customized bundles of DBG services to seize unique cost-of-care and quality improvement opportunities for client groups.

 
 

• Builds effective relationships with internal and external stakeholders.

 
 

• Understands the issues specific to the client and applies knowledge, insight and experience into strategic recommendations.

 
 

• Understands the business processes that the system supports.

 
 

• May develop product and sales support messaging and materials, and provide input into the design of an account planning and renewal strategy.

 
 

 
 

Qualifications

 
 

• Requires a BA/BS in health care related field; 7 years of experience in account management, sales and/or operations in the health care industry; or any combination of education and experience, which would provide an equivalent background.

 
 

• MBA preferred.

 
 

• Requires a successful track record of selling specialty care/benefit management services and technology for leading healthcare companies to target customers.

 
 

• Experience with Medicaid insurance strongly preferred.

 
 

 
 

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

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Found in: beBee S US

Description:

**Description** The Market Development Principal provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE product implementation, operations, contract compliance, and federal contract application submissions. The Market Development Principal provides strategic advice and guidance to functional team(s). Highly skilled with broad, advanced technical experience. **Responsibilities** The Medicaid Behavioral Health Business Development Principal provides support to assigned business development team and/or specialty companies relative to Medicaid mental health and substance abuse business strategy and solutioning, implementation, operations, contract compliance, and federal contract application submissions. The Market Development Principal provides strategic advice and guidance to functional team(s). Highly skilled with broad, advanced technical and Medicaid behavioral experience. Responsibilities The Medicaid Behavioral Health Business Development Principal serves as the primary resource and SME for business development. Ensures that RFP content and clinical model is meeting or exceeding corporate and state Medicaid requirements. Works with senior executives to develop and drive segment or enterprise-wide functional strategies. Advises one or more areas, programs or functions and provides recommendations to senior executives on matters of significance, and as an advanced subject matter expert competent to work at very high levels in multiple knowledge and functional areas across the enterprise. Required Qualifications + Bachelors Degree + Experience in fully integrated physical and behavioral clinical models + 10 years working experience in leading mental health and substance abuse Medicaid strategy for complex populations + 10 years working experience in leading Medicaid strategy for complex populations + 10 or more years of program design, execution and measurement in the Medicaid population + 5 years of project/people leadership + Experience as subject matter expert in Medicaid RFP process + Strategic thinking and planning capabilities + Organized and detail-oriented + Excellent presentation and communication skills, both internal and external audiences + Must be passionate about contributing to an organization focused on continuously improving consumer experiences + Able to effectively work in matrix organization and influence senior leadership level key stakeholders Preferred Qualifications + Graduate Degree + Experience evaluating competitor capabilities, determining where there are gaps and making recommendations to close them Additional Information *Limited travel **Scheduled Weekly Hours** 40
Categories

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