Author: Sarai McDowell

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Medicaid Job Hunter: 06/03/2019

We scour the internets for Medicaid jobs listings to save you time.

 
 

In this packet…

  1. Metroplus Health – Social Worker Job in New York, NY
  2. Cook County Government hiring DIrector of Finance, Medicare and Medicaid- County in Chicago, IL, US
  3. Metroplus Health – Registered Nurse (RN) Job in New York, NY
  4. Recruiting International hiring Health Plan Account Mgr CHC in Houston, TX, US
  5. Capgemini hiring Medicare/Medicaid/ Claims( Healthcare) – Supervisor/Lead in El Paso, TX, US
  6. Ivy Exec hiring Senior Director-Medicaid Health Plan in Scottsdale, AZ, US
  7. United Healthcare Health Insurance Sales Job in Knoxville, TN
  8. Independent Care Health Plan hiring Contract and Network Development Specialist – Family Care Partnership in Madison, WI, US
  9. Income Maintenance Caseworker II- Adult Medicaid Processing
  10. Eligibility Specialist, Medicaid/Medicare Jobs in Scottsdale, AZ – Centauri Health Solutions, Inc. 

Medicaid Industry Jobs Hunter 6.3.19

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Medicaid Who’s Who Interview: Meg Murray

Meg Murray is CEO at
Association for Community Affiliated Plans (ACAP)

Check out her LinkedIn profile HERE.

Which segment of the industry are you currently involved?

ACAP is a national trade association, representing 66 non-profit Medicaid Managed Care Plans that serve over 20 million lives in 29 states. Our safety net health plans provide care to nearly half of all people enrolled in Medicaid managed care plans.

How many years have you been in the Medicaid industry?

I started my career in Medicaid managed care in 1994 while working at the Office of Management and Budget, focusing on the Medicaid waivers during the Clinton Administration. Back then, fewer than 3 in 10 Medicaid enrollees were in managed care; today it is closer to 7 out of 10.

What is your focus/passion? (Industry related or not)

I’m dedicated to ensuring that all Americans have access to high quality health insurance and high-quality care—especially Americans with lower incomes. This has a lot to do with my family history —  my grandmother suffered a stroke when my father was quite young. The family didn’t have comprehensive insurance, and it took a toll on their financial security. My father used to always tell me how important it was to have good health insurance. That is what motivated me to work to ensure that a family doesn’t experience a financial catastrophe because of an illness.

What is the top item on your “bucket list?”

I’d like to spend another year in Germany looking at their health care system, so I could continue to see what the U.S. can learn from the German system. After graduate school, I spent a year in Germany studying their health care system through a fellowship program and was recently back there this past summer for a month to do more studies on the topic.

The German system includes an individual mandate, risk adjustment, a comprehensive set of required benefits, private providers and hospitals, and a robust competitive insurance marketplace. And it’s been that way for more than 135 years. As I pointed out in an op-ed last year, there’s a great deal we can learn from them.

I also want to improve my German language skills—a lot of it came back to me while I was in Germany, but I continue to read detective novels in German in attempts to maintain my skill level.

What do you enjoy doing most with your personal time?

I have two teenage sons, so I enjoy spending my time with them…when they let me! I am also an avid reader and belong to two book clubs. So, I’m constantly reading to keep up—I need to make sure I’m not thrown out! As a runner, my newest endeavor is training for a 10K.

Who is your favorite historical figure and why?

Susan B. Anthony. Right now, I’m fascinated with the women’s suffrage movement, especially considering how long it went on and the immense dedication these women displayed for their cause. Many suffragettes didn’t live to see the 19th amendment enacted. But their legacies live on.

What is your favorite junk food?

No contest: chocolate chip cookies. I try to bake them from scratch, but more often than not, they come straight from the tube. Still just as delicious!

Of what accomplishment are you most proud?

I am immensely proud of the advocacy work ACAP did to fight against the threat of repealing and replacing the Affordable Care Act in 2017, because the repeal would have meant massive cuts to the Medicaid program. We launched a successful social media campaign, “Medicaid is Us,” which resulted in published op-eds across the country, radio ads, more than 5,000 television spots, and news coverage in a wide array of markets.  Most notably, it generated more than 50,000 letters sent to Senators and Representatives, urging them to oppose cuts to Medicaid. We’re proud of our work to stand up and defend Medicaid.

What are the top 1-3 issues that you think will be important in Medicaid during the next 6 months?

Social determinants of health will continue to be important to ACAP Safety Net Health Plans. Looking after and caring for people’s needs holistically has oftentimes shown cost savings while improving health outcomes. However, many safety net plans utilize their own funds to address social determinants. That’s why our plans are constantly sharing best practices and also thinking creatively about external funding sources so they can sustain the great strides they’re making in addressing the social determinants of health.

Another important issue is churning in the Medicaid program. Every year, millions of people enroll in Medicaid, only to lose their coverage due to lost paperwork or slight changes in income, like receiving overtime pay. It’s been a hot-button issue in the news for the past few months, and likely will continue to be. To reduce the level of churning, there are two bipartisan Congressional bills that propose 12-month continuous eligibility for people that have Medicaid or CHIP. The passage of these bills would be monumental in ensuring people don’t lose their health coverage over minor glitches.

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Know someone in the space who’s doing great work and is an all around interesting person?

Send a note to clay@mostlymedicaid.com to nominate them for the next round of Medicaid Industry Who’s Who Interviews

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Menges Group 5 Slides Series for March 2019

The Menges Group puts out these great analyses and insights each month. And is kind enough to let us repost them for the MM audience. Check out themengesgroup.com to learn more about the work they do. 

This month’s edition analyzes and compares prescription volume and drug costs in the Medicaid and Medicare Part D programs. We tabulated pre-rebate cost per prescription for each program from 2013-2017.  We also analyzed trends in specialty drug volume and expenditures during the same time period for each program.

5 Slide Series- March 2019 – An Analysis of Medicare Part D and Medicaid Prescription Drugs

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Medicaid Job Hunter: 05/28/2019

We scour the internets for Medicaid jobs listings to save you time.

 
 

In this packet…

  1. Independent Care Health Plan Medicare Benefits Consultant in Green Bay, WI, US
  2. State of Florida 68064589 – CHIEF OF MEDICAID QUALITY Job in Tallahassee, FL
  3. IlliniCare Health Provider Network Specialist II in Chicago, IL, US
  4. Analytica International State Medicaid Program Director in Baltimore, MD, US
  5. Physicians Health Partners Senior Member Support Specialist (Medicaid) in Colorado Springs, CO, US
  6. IlliniCare Health Community Health Services Representative I in Carbondale, IL, US
  7. Fallon Health Registered Nurse Case Manager in Berkshire, MA, US
  8. WellCare Health Plans State President – Ohio in Columbus, OH, US
  9. Molina Healthcare Sr Program Specialist, Medicare in Long Beach, CA, US
  10. Medical Director (Aetna Better Health of Maryland) in Linthicum, Maryland, United States

Medicaid Industry Jobs Hunter 05.28.19

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Medicaid Job Hunter: 05/20/2019

We scour the internets for Medicaid jobs listings to save you time.

 
 

In this packet…

  1. IlliniCare Health – Referral Specialist I in Westmont, IL, US
  2. Pharmacy Provider Liaison at Centene Corporation
  3. MetroPlus Health Plan – MLTC Marketing Representative in New York City, NY, US
  4. Humana – Medical Management Coordinator – Louisiana Medicaid in Metairie, LA, US
  5. State of Colorado – Medicaid Director, Department of Health Care Policy & Financing in Denver, CO, US
  6. Mid West Apply – Supervisory Health Insurance Specialist with Centers for Medicare & Medicaid Services in Chicago, IL, US
  7. President, Medicaid Health Plan – New York City, New York, United States
  8. Centers for Medicare & Medicaid Services – Health Insurance Specialist. in Woodlawn, MD, US
  9. Licensed Behavioral Care Advocate Mississippi Medicaid Telecommute Field Based job at UnitedHealth Group
  10. President Medicaid Health Plan Jobs in Woodbridge Township, NJ

Medicaid Industry Jobs Hunter 5.20.19

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Medicaid Job Hunter: 05/13/2019

We scour the internets for Medicaid jobs listings to save you time.

 
 

In this packet…

  1. Health Care Cost Containment hiring PUBLIC HEALTH NURSING CONSULTANT in Phoenix, AZ, US
  2. Fallon Community Health Plan Clinical Assistant – Growing Elder Care Services Program – L Job in Leominster, MA
  3. Fallon Community Health Plan RN Nurse Case Manager – Looking for Spanish Speaking Nurse – Worcester, MA
  4. Health Care Cost Containment hiring HEALTH PROGRAM MANAGER 2 in Cottonwood, MN, US
  5. Health Care Cost Containment hiring DIRECTOR OF HOUSING in Phoenix, AZ, US
  6. HCA Healthcare hiring Medicaid Eligibility Advocate in Montgomery, AL, US
  7. Centers for Medicare & Medicaid Services hiring Supervisory Health Insurance Specialist. in Woodlawn, MD, US
  8. State of Louisiana hiring Medicaid Program Manager 1–b (health Plan Provider Network Compliance Manager) in Baton Rouge, LA, US
  9. Centers for Medicare & Medicaid Services hiring Health Insurance Specialist. in Washington, D.C., DC, US
  10. Medicaid Specialist I

Medicaid Industry Jobs Hunter 5.13.19

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Medicaid Job Hunter: 05/06/2019

We scour the internets for Medicaid jobs listings to save you time.

 
 

In this packet…

  1. Health Insurance Specialist. | Centers for Medicare & Medicaid Services
  2. Administrator, Medicaid Compliance | UPMC Health Plan
  3. DOM-Medicaid Nurse Bureau Director | MISSISSIPPI LIMITED
  4. Product Manager- Medicaid Programs | UPMC Health Plan
  5. Medicare/Medicaid Elig Sp | Jobs @ TheJobNetwork
  6. Team Lead Medicaid Eligibility Advocate | HCA Healthcare
  7. Director, Care Coordination for Medicaid and Vulnerable Populations – Oakland | Kaiser Permanente
  8. 68053305 – AGENCY FOR HEALTH CARE ADMINISTRATOR-SES | State of Florida
  9. Medicaid Health Systems Administrator 2 (20035332) | State of Ohio Jobs
  10. Healthcare Insurance Coordinator – Tempe | Acumen Physician Solutions, LLC

Medicaid Industry Jobs Hunter 5.6.19

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Medicaid Job Hunter: 04/22/2019

We scour the internets for Medicaid jobs listings to save you time.

In this packet…

  1. Deputy Director, Medicaid | State of Maryland
  2. Community Health Services Representative I | Sunflower Health Plan
  3. Medicaid Eligibility Specialist | Olympia, WA
  4. Nurse Medical Management l – Medicaid
  5. Managed Care Medicaid Credentialing Specialist | Brentwood, TN
  6. Care Coordinator | Independent Care Health Plan
  7. Program Coordinator I | IlliniCare Health
  8. Medicaid Eligibility Advocate
  9. Business Analyst II- Medicaid Programs
  10. Registered Nurse | Covington, TN

Medicaid Industry Jobs Hunter 4.22.19

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Medicaid Who’s Who Interview: David Kumpf

David C. Kumpf is the Chief Product Development Officer at Optimetra, In.c

Check out his LinkedIn profile HERE.

Which segment of the industry are you currently involved?

Broadly, business development for Medicaid MCOs and health and human services organizations working with the Medicaid population (Centers for Independent Living, home care agencies, and the like). While we develop many proposals for our clients in response to state and federal RFPs, we spend as much time on helping our clients identify, select, architect, and position the solutions that will help them be more effective at serving Medicaid beneficiaries in the future.

How many years have you been in the Medicaid industry?

I’ve spent nearly 28 years in healthcare consulting, beginning with commercial healthcare and then the federal TRICARE program. I began working in Medicaid in late 1999 – so, almost 20 years.

What is your focus/passion? (Industry related or not)

Bringing clarity, direction, and solutions for complicated problems. I love situations in which a room of a dozen people are trying to address an issue and are having a circular conversation about what to do; I listen, and then help illuminate a path – or choices – for them.

What is the top item on your “bucket list?”

I don’t think of life as being about ticking off items on a bucket list, but rather about seeking ways to learn, improve, and enjoy in different dimensions of mind, body, spirit, and family. What can I learn? How can I improve? So I’m always looking for opportunities to increase the breadth and depth of my knowledge about many subjects and for ways to try to raise my standard of practice for the things I already know how to do.

What do you enjoy doing most with your personal time?

Playing guitar. Riding a bicycle. Watching good TV or movies with my wife. Reading. Discovering great new (or new to me) music. And, apparently, being a Yorkie rancher (we have three).

Who is your favorite historical figure and why?

That’s practically impossible to answer. There are so many that have contributed (in positive ways) to shape the world we live in. Aristotle, Plato, Newton, Einstein, Curie, Washington, Adams, Lincoln, and scores of others. In my adolescence, I was a fan of General George Patton. More recently, Steve Jobs. The common thread between the last two is the single-minded obsession with realizing a vision – Patton with building the Third Army into a force for winning the war in Europe, Jobs with making complex technology intrinsically easy to use.

What is your favorite junk food?

Peanut M&Ms. Pizza, too, but if done right, it’s not so much junk food.

Of what accomplishment are you most proud?

Personally, having a wonderful wife to whom I’ve been married for 38 years; we have two successful children and a grandson.

Professionally, building Optimetra, with the help of my business partner (Holly Smith), into a successful consulting practice that has created exceptional results for our clients. Holly is running the company now as CEO, and I’m looking forward to where she takes the company next.

For what one thing do you wish you could get a mulligan?

I’m not a believer in obsessing over the past – everyone tries to make decisions based on the knowledge and ability they had at the time. Steve Jobs, in a commencement speech, said “You can’t connect the dots looking forward; you can only connect them looking backwards. So you have to trust that the dots will somehow connect in your future. You have to trust in something – your gut, destiny, life, karma, whatever.”

I do want to learn from what I did. I can’t always change it, but I can make different choices the next time. Or, if the context and timing is right, share it with others: “hey – I know you’re about to do such-and-such – you might consider…”.

What are the top 1-3 issues that you think will be important in Medicaid during the next 6 months?

At Optimetra, we are guiding our clients toward a unique value position in the market. Population health, value-based purchasing, and quality improvement are not independent disciplines – they are inextricably linked as part of a single system and member experience. In modern Medicaid, it is imperative to differentiate your organization from your competitors by listening to your customer(s) and prioritizing initiatives that have the highest probability of producing measurable improvements.

———————

Know someone in the space who’s doing great work and is an all around interesting person?

Send a note to clay@mostlymedicaid.com to nominate them for the next round of Medicaid Industry Who’s Who Interviews