Medicaid State Implementation Lead

Description:

**Description**


The Medicaid State Implementation Lead provides support to existing and new Medicaid implementations.


**Responsibilities**


The Medicaid State Implementation Lead works on projects of diverse scope and complexity with potential revenue projections over a Billion dollars. Critical thinking is required and this position is responsible for being a thought leader able to influence change and implement large-scale programs.


+ Develop internal and external partnerships and related strategies to meet requirements of varying dual eligible and Medicaid models.


+ Work collaboratively with a variety of cross-functional teams and thought leaders to deliver committed program capability.


+ New Business Development – primary responsibilities include:


+ As a representative of the Medicaid Implementation team, provide strategic leadership as we evaluate market entry strategies in pipeline markets and respond to Requests for Proposals for new lines of business.


+ Participate in the RFP Response process along with the Business Development team working closely with cross-functional Medicaid leaders to shape the Strategy and commitments.


+ Identify new and innovative opportunities and programs and work across the Medicaid leadership team to develop a plan to implement them.


+ New State and/or contract re-procurements – primary responsibilities include:


+ Developing and executing on the end-to-end business implementation model


+ State relationship management throughout the implementation process


+ Support new Market resources upon onboarding


+ Participate in business requirements sessions ensure all requirements are accounted for including maintenance and requirements tractability. .


+ Implementation Schedule creation and maintenance


+ Executive summary status reporting and issue/risk escalation


+ Owns key Project Meetings with Stakeholders and Leadership.


+ Actively participate in Business Readiness Validation and State Readiness Review.


+ Ensure compliance with coordinating CMS and State Medicaid regulations.


**Required Qualifications:**


+ Bachelor’s degree or equivalent experience.


+ 3 – 5 years’ experience with Medicaid/Medicare operations/healthcare experience.


+ 5 – 7 years managing large scale projects and cross functional teams.


+ Success in developing working relationships within a highly matrixed business environment.


+ Ability to analyze data and make informed recommendations.


+ Experience managing and facilitating with the ability to influence without having authority.


+ Act as a thought leader with strong verbal and written communication skills (ability to interact effectively with people at all levels within a team or internal division).


+ Strong critical thinking, problem solving skills; detailed and well organized.


+ Demonstrates accuracy and thoroughness, identifies process improvements, fosters quality in others.


+ Accepts responsibility, is self-motivated and accountable for achieving implementation and market satisfaction goals.


+ Works within deadlines, demonstrates independence, resourcefulness and self-management skills.


+ Works well within an ambiguous environment where direction is always subject change.


+ Ability to flow to the work as capacity demands change.


**Preferred Qualifications:**


+ Master’s degree.


+ Experience responding to state and/or federal government solicitations.


+ Knowledge of Humana’s internal policies, procedures and systems.


**Scheduled Weekly Hours**


40

 
 

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