Director of Medicaid Services

🕒 Outubro 14

🇺🇸 Estados Unidos – Remoto (EUA)

💵 $132.000 - $162.000 / ano

⏰ Tempo Integral

🔴 Especialista

👔 Diretor

👻 Score fantasma 2%

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• Aberta há 30 dias.
• As vagas desta empresa costumam ser preenchidas em 26 dias.

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Health Services Advisory Group, Inc. (HSAG)

SiteLinkedInTodas as Vagas

201 - 500 funcionários

Fundada em 1979

🏥 Saúde

⚕️ Seguro de Saúde

🏛️ Governo

Healthcare • Healthcare Insurance • Government

A Health Services Advisory Group, Inc. (HSAG) é uma organização de melhoria da qualidade em saúde orientada por missão, que faz parceria com agências federais e estaduais, planos de saúde e prestadores para aprimorar a prestação de cuidados e os resultados dos pacientes. A HSAG oferece ciência de dados e análises avançadas, administração de pesquisas, revisão de prontuários médicos, auditorias e serviços de consultoria em saúde para apoiar programas de qualidade do Medicare e Medicaid, avaliações de isenções, iniciativas de saúde renal e pesquisas nacionais com pacientes. A organização foca em conformidade regulatória, medição de desempenho e melhoria da qualidade baseada em evidências para promover melhores resultados ao longo do continuum de cuidados em saúde.

Descrição

• Provide strategic and operational leadership for an assigned portfolio of Medicaid Services external quality review contracts, state customers, and programs • Ensure alignment with contract requirements and applicable state and federal requirements • Serve as senior relationship leader for state Medicaid agencies, managed care entities, subcontractors, and other stakeholders • Direct project planning, implementation, and performance monitoring across scope, staffing, schedules, budgets, and deliverables • Lead and coach project managers and assigned staff; set expectations, monitor performance, support development, and foster accountability and collaboration • Manage recruitment, selection, onboarding, training, evaluation, counseling, and corrective action for assigned staff • Ensure customer deliverables are accurate, high quality, internally reviewed and approved, and submitted on time • Use SharePoint and Copilot to streamline workflows and improve deliverable production • Monitor financial performance, staffing plans, labor utilization, budgets, and forecasts • Identify and mitigate operational, contractual, staffing, and customer risks; escalate significant concerns • Advise project leads on project design, data collection and abstraction, analysis, quality review, technical assistance, training, and report development • Advance standardized, scalable processes and continuous improvement, innovation, and knowledge sharing • Coordinate with HSAG departments and shared services to resolve cross-functional issues and support contract execution • Lead or support business development activities, including proposals, presentations, scope development, and pricing assumptions • Support division planning, resource allocation, succession planning, performance reporting, and organizational priorities • Represent HSAG in customer meetings, presentations, conferences, and external forums • Maintain confidentiality and comply with company policies, contractual obligations, and regulatory requirements

🎯 Requisitos

• Master's degree in healthcare administration, public health, health services, business administration, or a related field, or an equivalent combination of education and relevant experience • Minimum of eight years of progressively responsible experience in Medicaid, managed care, healthcare quality, external quality review, regulatory oversight, auditing, consulting, or related field • Minimum of five years of management or supervisory experience, including responsibility for complex projects, customer relationships, budgets, and staff performance • Demonstrated experience leading multiple contracts or large, complex initiatives or projects and delivering results through other leaders and cross-functional teams • Experience with state Medicaid agencies, Medicaid managed care organizations, external quality review activities, or related state and federal healthcare programs preferred • Experience supporting proposal development and business growth activities preferred • Excellent leadership, judgment, problem-solving, decision-making, and organizational skills • Excellent oral and written communication, presentation, facilitation, negotiation, and interpersonal skills • Ability to establish credibility and effective working relationships with customers, executive leaders, staff, subcontractors, and external stakeholders • Ability to analyze complex operational, contractual, financial, and customer issues; develop practical solutions; and communicate recommendations clearly • Ability to manage competing priorities, multiple projects, and overlapping deadlines while maintaining attention to detail and quality • Proficiency with Microsoft Windows and Microsoft Office applications, including Microsoft Copilot, and ability to learn and use other business software • Ability to maintain confidentiality and consistently represent HSAG in a professional manner • Ability to travel statewide and out of state as needed

🏖️ Benefícios

• Salaried full-time exempt position • Remote work arrangement • Reasonable accommodations for individuals with disabilities • Limited travel, generally less than 5 percent

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