Description:
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Director, Medicaid and SNP Product & Strategy Description
This position is responsible for assigned Medicaid and SNP product portfolio development and management. The Director will design, implement, maintain, document and analyze current Medicaid and SNP plans, as well as identify, prioritize and develop strategy for product expansion to continuously improve Medica’s Medicaid and SNP market position while working to align products and program offerings with state procurement cycles.
This role will work closely with Medicaid and SNP segment leadership, actuarial, network, sales, operations, marketing, and physician & health services to develop and communicate product intent, and ensure accurate and complete understanding and administration both internally, in the marketplace and with state and federal regulators.
Incumbent must have a proven track record with Medicaid and SNP products and understand the operational, clinical and financial implications of plan designs. Director is subject matter expert on Medicaid and SNP plan performance including membership, income, and operating margin. Position will also implement and manage strategic partnerships, alternative payment arrangements and external vendors.
Qualifications:
- Bachelor’s degree or equivalent combination of education and experience required
- 10+ years Medicaid, Medicare or SNP experience with a track record of successfully leading growth initiatives
- 5+ years leadership experience required
- Medicaid and SNP Products plan benefit design, bid development and operational implementation
Specific types of experience or skills required:
- Product performance monitoring, establishing metrics to measure product success
- CMS and DHS compliance and understanding of MCO regulatory environment
- Health plan operations understanding
- Analytical ability in business planning and financial management
- Demonstrated leadership and influencing skills with the ability to lead and drive change
- Strong communication and presentation skills
- Strong strategic planning skills
- Financial performance measurement skills, accountable for results
- Ability to articulate vision and strategy
- Passionate about member experience and recognized as a positive change agent who can work effectively in creating direction and influence to effective results
- Team player with strong relationship building skills at all levels of the organization and externally
- Creative problem solving skills using innovative approaches
- Ability to handle multiple complex projects with a high degree of engagement
- Strong drive for results and accountability
- Expertise in project development and implementation management
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)
3 days ago