Category: Curator- Job Hunter

 
 

Job Description

*** This role will allow the opportunity to work 2 days a week from home *** Job Purpose: This position is responsible for leading the business development growth of our Medicaid programs, the identification of new business opportunities; development of a Medicaid solution and approach for RFI/RFP responses. This position is a subject matter expert on Medicaid business development opportunities for the enterprise, working closely with stakeholders across the enterprise to educate on Medicaid business goals and partner on Medicaid product and program implementation activities. This position is responsible for managing and developing direct reports and indirectly managing matrix teams to support various Medicaid quality performance initiatives. Required Job Qualifications: Bachelor’s AND 4 years of experience operations; OR 8 years of experience in health insurance operations. 3 years of experience leading and managing teams. Experience in project management. Experience managing operations for Medicaid, Dual Demonstration or other related Medicaid Medicare Advantage programs Experience in business planning, time management, project management and organization skills with ability to multitask and manage multiple, concurrent projects and priorities. Experience planning and driving business initiatives through implementation. Executive presence with the ability to influence inside and outside HCSC. Demonstrated ability to manage multiple complex priorities. Business and financial acumen; experience with operating, capital budgeting and financial forecasting. Experience leading and formulating a strategy and delivering results; building strong connections with people and teams. Experience working in a matrixed organization across multiple geographic areas. Knowledge of the external market, competition and regulatory environment to create value for the enterprise. Preferred Job Requirements: 3 years of experience with Medicaid Managed Care. Knowledge of health plan systems, work processes, roles and inter-relationships with overall organization. Medicaid procurement experience Experience working with Medicaid state agencies and regulators Strong communication skills *CA #LI-AK1 #LI-HYBRID HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

 
 

Clipped from: https://b-jobz.com/us/web/jobposting/11f78457b78e?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

Alkermes, Inc. is the U.S. operating company of Alkermes plc, a fully integrated, global biopharmaceutical company that applies its scientific expertise and proprietary technologies to research, develop and commercialize, both with partners and on its own, pharmaceutical products that are designed to address unmet medical needs of patients in major therapeutic areas. Alkermes has a diversified portfolio of marketed products focused on central nervous system disorders such as addiction and schizophrenia and a pipeline of product candidates in the fields of neuroscience and oncology. Headquartered in Dublin, Ireland, Alkermes has a research and development (“R&D”) center in Waltham, Massachusetts; an R&D and manufacturing facility in Athlone, Ireland; and a manufacturing facility in Wilmington, Ohio.


The following position is for Alkermes, Inc.


The Manager, Medicaid Operations – Contracts & Pricing, will lead and support the Medicaid team’s day-to-day operations and other key processes within the Contract & Pricing department. Areas of ownership include but are not limited to overseeing and performing Medicaid claims processing, contract maintenance, data management, report generation, trend analyses, documentation, and cross-departmental collaboration.


The position reports to the Manager, Government Rebate Operations.


Key Responsibilities

• Lead, perform and continually enhance the end-to-end Medicaid claims adjudication process
• Review and update of Medicaid Rebate Processing system (MRB) in Model N®
• Setup and maintenance of Medicaid Contracts terms and prices
• Analyze rebate calculations for consistency and accuracy, research variances, and resolve disputes
• Communicate with state Medicaid contacts regarding payments and disputes as needed
• Execute various Medicaid state reporting activities required for data reconciliation
• Identify and assist in process and system improvements
• Ensure Preferred Drug List (PDL) status is verified every quarter
• Ensure proper Claim Level Detail (CLD) analysis and validation without oversight
• Prepare and provide Medicaid rebate reports and trend analyses to internal stakeholders
• Collaborate with Alkermes teams to support necessary updates to systems in accordance with guidance from CMS, OIG, OPA, and other regulating entities
• Support ongoing ad hoc requests and projects
   

Other Areas Of Focus Include

• Review, maintain and improve existing Standard Operating Procedures (SOPs) and Work Instructions (WIs)
• Ensure TriCare, IFF, and Coverage Gap payments are accrued for and paid within the mandated timeline
• Work with vendor / consultants as needed
• Participate in the internal and external audit related process (accruals, financial close process, etc.)
• Limited travel to home office may be required based on business needs
• Attend conferences and industry meetings as necessary (est. 5% to 10% travel)
• Bachelor’s degree required (Master’s degree a plus)
• 8+ years of professional experience
   

Preferred Skills And Knowledge Requirements

• 5+ years of pharmaceutical manufacturer Medicaid experience preferred
• 3+ years of RMS experience (e.g., Model N®, Revitas, or similar platform) preferred
• Expertise in MS Excel, PowerPoint, and Word
• Strong organizational, analytical, and communication skills
• Effective time management capabilities
• Understanding of the current healthcare landscape
• Experience managing full-time direct-reports a plus
• Understanding corporate finance is a plus
   

Alkermes, Inc. is an equal employment opportunity employer and does not discriminate against any applicant because of race, creed, color, age, national origin, ancestry, religion, gender, sexual orientation, gender expression and identity, disability, genetic information, veteran status, military status, application for military service or any other class protected by state or federal law. Alkermes also complies with all work authorization and employment eligibility verification requirements of the Immigration and Nationality Act and IRCA. Alkermes is an E-Verify employer.


Experience Level


Mid-Senior Level


 

Clipped from: https://www.linkedin.com/jobs/view/manager-medicaid-operations-%E2%80%93-contracts-pricing-at-alkermes-3137862077/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

Job Description

UnitedHealthcare is a company that’s on the rise. We’re expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn’t about another gadget, it’s about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life’s best work.(sm) This position provides leadership for the Community and State Health Plans Medicaid products in their assigned market to drive membership/sales growth.  The position is a member of the health plan senior leadership team and will work collaboratively with the CEO, COO and CFO to ensure overall strategies are aligned with the market level business objectives.  This role will support NJ FamilyCare (Medicaid) sales channel to drive community relationships, sales activities/enrollments, and member retention. This role will be accountable for meeting enrollments targets, developing and deploying a sales plan, providing leadership presence in the community, and combating competitive pressures.   This position is responsible for analyzing market conditions, develop forecasts, estimate costs, manage program budgets, and drive execution of growth levers through other functional departments.  This is an external and internal facing role.   If you are located within East Coast State, you will have the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities: Develop and execute a sales plan for Medicaid product offering to achieve growth goals and member retention Conduct/utilize market/competitive analysis to drive understanding of local market opportunities and requirements to drive strategy Evaluate, build, and lead sales channel(s) for the market  Drive smart Growth in membership and market share by influencing growth levers across segments and departments (Network, marketing, clinical, quality, finance) Lead, develop and uphold accountability of Medicaid products forecasting models with complete understanding of auto assignment algorithms, eligibility requirements, self-select, and involuntary vs voluntary term ratios Manage local Medicaid field-based teams and work directly with M&R regional sales leaders to leverage DSNP Outreach strategies and teams across segments Partner with local and functional teams to assure appropriate benefit design and value-added services  Formulate impactful relationships that drive engagement with community-based organizations, faith-based organizations, and providers Develop and implement provider engagement strategies (including Field-based approaches and face to face visits Providers) in partnership with Network partners that specifically focuses on membership growth and retention and making UHC the insurer of choice for UHC Lead and provide oversight for the Field community outreach team that orchestrates member events, potential consumer events, and community-based goodwill and general awareness that make UHC the insurer of choice Manage and uphold accountability for marketing, sponsorship, and outreach budgets Represent the Health Plan at State meetings, community events, and media relations Assist in developing new geography/product opportunities  Ensure compliance to health plan State contract for MCO functions entailing Sales, Marketing, Communications, Engagement with Community Based Providers and Provider Network and outreach activities Lead and develop top field talent in designated markets, while creating bench strength and opportunities for professional growth within the team Develop and execute and continually update overall strategies for Medicaid product  offering to maximize product growth, member retention, innovation and member and provider experience  Drive smart Growth in membership and market share in designated market by developing solid relationships across segments and departments (Network, marketing, clinical, quality, finance) Must be able to flex strategies to address local market nuances and unique requirements to assure that we are keeping healthcare “local” while maintaining a strong presence in the market Assist in implementing future product opportunities  Develop social determinants program for designated health plan You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: Bachelor’s degree 10+ years of experience in sales/growth roles in the Medicare/Medicaid space   5+ years of leading sales/growth teams  Experience using analytical skills to conduct competitive analyses, ROI or cost/benefit analyses, prepare forecasts and market trends Experience working with cross-functional teams to achieve outcomes Managed care experience  Experience working with C-suite leaders  Proven track record developing and deploying successful market/sales strategies/tactics Proven track record developing and deploying market strategies  Excellent presentation skills Travel up to 50% of the time  Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation Preferred Qualifications: Master’s degree (MPA/MBA) Active health license Market experience  Bi-lingual (Spanish) To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That’s why you’ll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life’s best work.(sm) *All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy. Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

 
 

Clipped from: https://b-jobz.com/us/web/jobposting/0aceb49c9d80?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

Location: Remote work environment in Nebraska, preferably close to an office location. The Medicaid State Operations Director is responsible operations functions, including coordination between internal departments, ensuring the appropriate strategy,…Operations, Director, Operation, Manufacturing, Healthcare, Health

 
 

Clipped from: https://www.linkedin.com/jobs/view/nebraska-medicaid-state-operations-director-at-elevance-health-3152559011/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

Job Description

JOB DESCRIPTION


Job Summary


Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.


KNOWLEDGE/SKILLS/ABILITIES

• Completes comprehensive assessments of members per regulated timelines and determines who may qualify for case management based on clinical judgment, changes in member’s health or psychosocial wellness, and triggers identified in the assessment.
• Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals and member’s support network to address the member needs and goals.
• Conducts face-to-face or home visits as required.
• Performs ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Maintains ongoing member case load for regular outreach and management.
• Promotes integration of services for members including behavioral health care and long term services and supports/home and community to enhance the continuity of care for Molina members.
• Facilitates interdisciplinary care team meetings and informal ICT collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
• Assesses for barriers to care, provides care coordination and assistance to member to address concerns.
• 25- 40% local travel required.
• RNs provide consultation, recommendations and education as appropriate to non-RN case managers.
• RNs are assigned cases with members who have complex medical conditions and medication regimens
• RNs conduct medication reconciliation when needed.

JOB QUALIFICATIONS

Required Education

Graduate from an Accredited School of Nursing. Bachelor’s Degree in Nursing preferred.

Required Experience

1-3 years in case management, disease management, managed care or medical or behavioral health settings.

Required License, Certification, Association

Active, unrestricted State Registered Nursing (RN) license in good standing.

Must have valid driver’s license with good driving record and be able to drive within applicable state or locality with reliable transportation.

Preferred Education

Bachelor’s Degree in Nursing

Preferred Experience

3-5 years in case management, disease management, managed care or medical or behavioral health settings.

Preferred License, Certification, Association

Active, unrestricted Certified Case Manager (CCM)

Clipped from: https://www.ziprecruiter.com/c/Molina-Healthcare/Job/Field-Remote-Medicaid-Care-Coordinator/-in-Long-Beach,CA?jid=ba46db9a0e147ead&utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

Government and Public Service Sales Executive – Medicaid Enterprise Solutions Deloitte has a dominant presence in the Medicaid Enterprise Systems (MES) space. We are the market leader in MES modular solutions for state government including systems integration and analytics and data warehousing platforms.

Deloitte also provides other state healthcare solutions and services, and desires to expand its offerings and market share. We wish to hire a sales executive with a mature understanding of State Medicaid programs, and who has existing client relationships with State Health and Medicaid agencies. The ideal candidate must have knowledge and experience selling Medicaid modular systems and/or other relevant state enterprise healthcare systems.

Job Responsibilities: The sales executive will drive new business for Deloitte’s Medicaid Enterprise Solutions. The SE will strategically collaborate with Account and Practice leadership to position and sell our MES offerings. Specific responsibilities include: + Develop leads, cultivate a targeted list of prospects and lead sales efforts within a targeted set of states working closely with Account and Practice leaders + Develop relationships and collaborate with Deloitte leadership to formulate and execute on a go-to-market strategy + Understand the competitive landscape and client needs in order to effectively position MES and Deloitte’s consulting services + Identify and influence key decision-makers at all levels within the client organization + Assist account teams and practice leaders with qualifying, pursuing and closing opportunities + Play a leadership role/drive pursuits and contribute to the development of proposals and coach the team through orals preparation.

+ Represent Deloitte by spending time in the field, and at conferences/policy forums + Develop strategic and tactical plans to meet or exceed sales objectives + Maintain accurate and timely customer, pipeline, and forecast data working with Sales Operations team The ideal candidate will have a significant level of Medicaid, MMIS or similar business development and executive relationship experience with a proven track record in selling consulting services. The candidate will understand how to develop go-to-market plan that targets the Medicaid/MMIS consumer. The candidate will understand the professional service delivery process and ideally will have experience delivering engagements at some point within their career.

Candidates should have a minimum of 5-10 years of relevant experience. Required Experience and Qualifications + 5-10 years of experience as a named account executive and/or business development manager serving State and Local clients + Strong consulting, Health and Human Services and Medicaid background. In-depth understanding of the state government Medicaid enterprise industry and key business issues + Demonstrable ability to leverage pre-existing network of clients or contacts in the marketplace + Proven ability to develop and secure relationships at all levels within a client organization + Ability to integrate, influence, and collaborate with cross-functional teams in client pursuits + Bring executive presence, poise and a commitment to superior quality in all aspects of work + Ability to travel 70%, on average, based on the work you do and the clients and industries/sectors you serve + Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future.

Preferred: + Bachelor’s degree EA_ExpHire EA_CMG_ExpHire SalesOpsGreenDot All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or protected veteran status, or any other legally protected basis, in accordance with applicable law

 

To apply for this position you will complete an application form on another website provided by or on behalf of Deloitte. Please note ComputerJobs – Texas Jobs is not responsible for the application process on any external website.

 
 

Clipped from: https://texas.computerjobs.com/search-jobs-in-Houston-Texas-USA/GOVERNMENT-AND-PUBLIC-SERVICE-SALES-EXECUTIVE-MEDICAID-ENTERPRISE-SOLUTIONS-6c2a6463cf41f75bb6/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

Description:

CATHOLIC HOSPICE INC.

SOCIAL WORKER

BILINGUAL ENGLISH / SPANISH

WORKING FOR ADMISSIONS – FULL TIME POSITION

DISCHARGE PLANNING, PLACEMENTS, MEDICAID APPLICATION ASSISTANCE

MIAMI LAKES, FLORIDA

Summary & Objective

The Social Worker provides social work services primarily on a visiting and intermittent basis in the Inpatient Unit in accordance with the policies and procedures of Catholic Palliative Care Services.

Essential Functions

• Assess patient’s needs in the Inpatient Unit within established time frames within organizational, state and federal regulations.
• Provides individual counseling of patients and family members coping with terminal illness.
• Administers individual and family psychosocial support depending on individual need and state compliance.
• Evaluates and assesses patient and family to determine coping strategies related to grief.
• Develop treatment plans in accordance with outcome of evaluation while collaborating with interdisciplinary team members.
• Completes clinical note, psychosocial and financial assessments, interdisciplinary notes, bereavement assessments, etc., and gives copies to appropriate Manager.
• Facilitates crisis intervention working with community organizations and interdisciplinary team members to ensure patient and patient-family unit psychosocial care.
• Attends group meetings, individual and family interviews during the evening hours as needed.
• Provides written weekly schedule to Clinical Care Manager in an effort to maintain compliance and deliver psychosocial support.
• Instruct, treat, observe and evaluate patients exhibiting significant social and emotional problems affecting their health status.
• Implement the Plan of Care provisions to meet their needs, which include: social service goals for alleviating problems, supportive counseling, problem solving, community referrals, etc.
• Provides coordination and liaison service between Hospice caregiver and community agencies, hospital caregivers, funeral directors, lawyers, schools, etc.
• Provides referral services for the patients and families to the community agencies for needs beyond the scope of Hospice care, such as long-term therapy, psychiatric care, financial assistance, etc.
• Provides Bereavement counseling services to families of patients who received hospice care in a variety of treatment modalities including individual, family and group.
• Complete appropriate documentation in a timely manner to assure compliance with agency policy.
• Participate in the development and periodic re-evaluation of the physician’s Plan of Care (POC).
• Instruct and counsel patients and families in treating and coping with social and emotional response connected with the illness.
• Regularly assess the patient and family psychosocial needs.
• Regularly assess the pre-bereavement/anticipatory grief needs.

 
 

• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position.

Other Duties

• Apply concepts of agency’s infection control plan and universal precaution in coordination/performing client cares activities to protect both patient and staff (OSHA).
• Demonstrates knowledge of hospice levels of care, Medicare and Medicaid Hospice Benefits by providing appropriate documentation when the need arises.
• Participates in educational and developmental programs to enhance his or her ability to provide therapeutic services to patients, families, staff and the community.
• Knowledge of community resources to make referrals to agencies and coordinate services with patient-family units.
• Implements a comprehensive discharge plan.
• Utilizes Support Services Coordinator to gain input, seek resources and to obtain clinical supervision.
• Provides community education in the form of workshops, lectures, etc.
• Participates in orientation, team meetings, staff development and other interdisciplinary meetings.
• Accounts to the Support Services Coordinator for appropriate use of work logs in providing both service to patient/families and service to Hospice Staff and community.
• Ability to participate as an integral member of the interdisciplinary team in providing supportive services to patients and families through On-Call system.
• Exhibit high comfort level in dealing with terminal illness.
• Consistently able to work calmly and maintain effectiveness in situations of high stress.
• Maintaining the ability to extend hospitality and patience while assisting patients, families, physicians and peers under stressful circumstances.
• Demonstrate commitment and professional growth by participating in in-service programs and maintaining/improving competency.
• Maintain the highest standards of professional conduct in relation to information that is confidential in nature. Share information only when recipient’s right to access is clearly established and sharing of such information is in the best interest of the patient.
• Meet mandatory continuing education requirements of the agency/licensing board
• Maintain your required licenses, certifications and mandatory skill updates.
• Comply with all policies, local, state and federal laws and regulations.
• Provide other duties of healthcare team member.
• Perform other duties as assigned.

Supervisory Responsibility

• May serve as an interim department leader depending on need

Physical Requirements

• Must be able to lift and/or move up to 50 pounds and push/pull up to 250+ pounds, walk, climb stair or ladders, stand on feet for extended periods of time, etc.

Disclaimer

The job description is not designed to cover or contain a comprehensive listing of activities duties or responsibilities that are required of the employee. Other duties, responsibilities and activities may change or be assigned at any time.

EEOC Statement

CHS provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

PM19

. Requirements:

Knowledge & Experience Requirements

• Master’s Degree from a school of Social Work accredited by the Council on Social Work Education.
• Clear and Active Professional License to practice in the state of Florida.
• 1-2 years of social work experience in a health care setting. Hospice experience preferred.
• Knowledge of AHCA Regulations, Medicare COP’s Guidelines required.
• Must have knowledge of computer office/clinical software.
• Must be able to read, write and understand the English language.

 
 

Clipped from: https://www.glassdoor.com/job-listing/social-worker-admissions-dc-planning-placements-medicaid-app-assistance-miami-lakes-catholic-hospice-inc-JV_IC1166161_KO0,83_KE84,104.htm?jl=1007775480026&utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

Job Description

Position Summary Senior Manager / Specialist Leader, Government and Public Services Healthcare (Medicaid)Position SummaryThe successful candidate will be a senior member of Deloitte’s Government and Public Services consulting organization in the United States. The candidate will serve as a senior team leader on project engagements and lead the development and growth of the practice in support of state and federal government agencies, primarily on Medicaid related issues. Deloitte State Healthcare ConsultingWith more than 40 years of experience in assisting state health and human services agencies in nearly every state, Deloitte understands how delivery works—and how it can work better. Our state health team offers industry-leading insights, solutions, and business practices to help state health agencies solve their most difficult challenges, ranging from modernization of eligibility determination systems and compliance with Federal Health Insurance Exchange requirements to innovative Medicaid tools and services that can help states serve their constituents more effectively.Deloitte helps state Medicaid agencies design and implement initiatives that improve upon the management of their health programs, overall financial performance, and health outcomes. Our advisory services and solutions focus on four critical areas: policy and program design, analytics, organizational transformation, and ongoing program evaluation. In an environment in which states are being asked to do more with less, Deloitte brings a wealth of knowledge, experience and solutions to help health agencies plan for the future. The RoleThe Senior Manager will focus on selling and delivering consulting services in support of state Medicaid Directors’ agendas. They will help clients manage forward and transform themselves through a highly complex and ever-changing business environment. Consulting services and solutions would include generating new ideas for clients that will help them in this transformational journey and that generate a positive return on investment (ROI). The work will be rooted in the creation of innovative customer engagements for clients, building and leading a world-class team, and driving the development of thought leadership and offerings to create value for clients. Specific responsibilities and expectations include leading client service delivery, sales and marketing, and management of engagement teams.Requirements: At least 10 years of healthcare experience working either with a state Health and Human Services agency or with a health plan or consulting company serving healthcare clients. Demonstrated experience working on Medicaid related issues including Medicaid managed care, value-based purchasing, 1115 transformation waivers, social determinants for health, managed long term services and supports, home and community based services, physical and behavioral health coordination, Medicaid enterprise solutions, quality measurement and analytics and fee for service operationsTrack record of leading and growing strong teams of management consultants or other organizational groups, with ability to manage across multiple engagementsOutstanding leadership skills, verbal and written communication skills, presentation skills, team working skills and ethical standards. This individual should be looked upon as a role model who instills the pride, values and integrity of Deloitte in their team. Experience supporting Medicaid programsExperience mentoring and coaching othersBusiness development experience (pre-sales, proposal, and RFP experience)Experience leading teams and managing client/executive relationshipsWillingness to travel at least 25%Masters Degree PreferredQualifications: Anticipates client needs based on a strong understanding of the client and its industry and marketplace.Determines client needs by guiding teams in selecting and applying the most appropriate tools, techniques, and approaches to understand the client’s issues and opportunities.Integrates recommendations into a total solution for the client that is consistent with the engagement strategy.Challenges and enhances quality by consistently striving for ways to improve deliverables.Directs the team to provide exceptional service to the client by responding with a sense of urgency, practicality, accountability, integrity, and respect.Communicates regularly with client management on a variety of business topics (e.g., trends, innovations, problem-solving discussions)Demonstrate specific service area/competency and/or industry expertise that resulted in tangible value for the client.Demonstrates a thorough knowledge of market trends, including opportunities and competitor activities in market assessments.Contributes to innovative thought leadership expertise, such as leading the development of complex, market-valued intellectual capital.Leverages their business network for contacts in target market to generate leads and brings ideas on innovative ways to identify and pursue new cross-functional sales opportunities, where appropriate.Leads development of the sales pursuit strategy and assembles and effectively manages the sales pursuit plan.Demonstrates the ability to successfully close the sale and generates enthusiasm in potential clients about working with the Firm.

 
 

 
 

Clipped from: https://b-jobz.com/us/web/jobposting/14010ad61658?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

Exciting opportunity to lead new government programs at an innovative, rapidly growing care management company that leverages technology to meet human touch.


The Government Programs and Government Relations team leads the organization’s growth efforts by engaging with States to promote and expand the services within identified markets.


Reporting to the SVP, New Program Development, the Director of Business Development for Government Programs partners with State leaders in Medicaid agencies to develop and implement comprehensive family caregiver support programs as Medicaid benefits. In collaboration with other team members, this individual’s primary responsibilities will be to present the company’s services to prospective clients and secure new State contracts.


Responsibilities

• Research and analyze industry trends and environmental and competitive conditions generally and in identified markets
• Develop a strategic engagement plan for each identified State market that is consistent with company’s objectives and core values
• Implement engagement plans efficiently to assess client needs and facilitate alignment with Seniorlink services
• Establish and maintain trusted and productive relationships with potential clients throughout the business development cycle
• Identify and recommend additional potential client opportunities
• Develop and present reports to update leaders on progress, business learnings, and market trends
  
  

Qualifications

• 10+ years’ experience in the healthcare industry in a business development or program development role; experience working within a Medicaid agency highly preferred.
• A working knowledge of Medicaid programs including delivery systems for long-term services and supports required
• Demonstrated ability to work independently, as a part of a small team, and in larger cross-functional project teams
• Excellent communication skills (verbal, written, and presentation)
• An entrepreneurial and optimistic mindset
• A Bachelor’s degree is required
• Ability to travel; travel will be planned and predictable
  
  

This is a 100% remote role with some travel. Competitive base salary, incentive bonus and benefits available.

Contact Information

________________________________________________

Clipped from: https://www.linkedin.com/jobs/view/director-medicaid-programs-at-max-populi-3158321293/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

Found in: Talent US Sponsored – 22 hours ago

Jefferson Township, United States Conduent Full time

Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments – creating exceptional outcomes for our clients and the millions of people who count on them.

You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day.

Job Description

Senior Manager, Service Delivery-PBM/Medicaid (Onsite) – Jefferson City, MO

(position MUST BE on-site in Jefferson City, MO and requires relocation) No remote/WFH

(Relo assistance is provided)

Summary:

The Senior Manager, Service Delivery leads the Operations and IT Service Delivery teams as the point of contact

• Directs the efforts of four major operational areas (call center, mail center, provider relations and drug rebate) for Pharmacy Benefits Management administered by the state’s Medicaid department

• Liaise between state and technical development/support teams for release management efforts and delivery escalations

• Provide leadership for day-to-day operational delivery for onsite & remote resources

• Lead service delivery experience to the customer by being the single point of ownership and accountable

• Establish and maintain customer relationships

• Set a vision, strategy, and execution plan for team members

Qualifications

• Education: Bachelor’s degree in a related field

• Experience: 10 years Operations Leadership including Pharmacy Contact Center Ops

• 2+ years Project Management experience (PMP preferred)

• Pharmacy Benefits Management (PBM) experience

• NCPDP healthcare solutions development standards

• Proficiency with Microsoft Office suite

• Excellent communications and interpersonal skills

 
 

 
 

Clipped from: https://us.trabajo.org/job-1448-20220706-86d2fc05715a3386ae218a9e44ef763b?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic