Category: MM Curator

Automated Health Systems, a dynamic and entrepreneurial healthcare company, is hiring a motivated and experienced management professional.

As the Eligibility
Program Manager, you will be responsible for leading Eligibility Agent Services in multiple counties in Indiana.

Qualifications for the position include:

• Minimum 5 to 7 years’ direct management experience with maternal and child health programs required.
• Previous enrollment and eligibility experience strongly preferred.
• Strong technical proficiency to learn new software programs.
• Ability to analyze data to balance workloads across offices.
• Must possess knowledge of Medicaid or IN health care programs (i.e., Hoosier Works).
• Bachelor’s Degree in related field or equivalent training/experience required.
• Some travel required.

In addition to comprehensive and ongoing training, we offer full-time employees a suite of benefits, including health insurance, and dental and vision insurances.

Clipped from: https://www.indeed.com/viewjob?jk=a5e799ac86c79718&tk=1eplnstcsu3mj800&from=serp&vjs=3

Manager of Capture Planning – Medicaid – Remote Position

Available: November 2020

The Manager of Capture Planning will join a terrific employer and focus on securing bids and developing Medicaid business in states across the US. This position will oversee a staff of 2, lead development and execution of capture plans for RFPs, manage the process of pursuing a bid, and develop a winning plan. Candidates should This position is a permanently remote opportunity!

Job details

Salary

$110,000 – $140,000 a year

Job Type

Full-time

Number of hires for this role

1

Qualifications

• Bachelor’s (Preferred)
• Business Development: 5 years (Preferred)

Manager of Capture Planning – Medicaid – Responsibilities

• In collaboration with the Market President or Market Development Director/Manager, the Vice President, Market Entry, and other senior level decision makers, defines the strategic direction for procuring (i.e. capturing) new and existing business.

• Direct internal resources in order to: identify customer issues, find priorities and hot buttons; stage gate evaluation of the opportunity; development of opportunity strategy and win themes; identification, analysis, development, documentation, and approval of solutions; capture risk assessment and management; acquisition of data and other proof points to support a strong proposal.

• Guides analysts and consultants on research of customer priorities, national trends, and solution alternatives

• Establishes and leads cross functional work streams to arrive at informed strategic and tactical decisions, develop the capture planning deliverables, and execute the capture plan.

• Contributes to process improvement efforts to improve efficiency, effectiveness, and quality of capture deliverables.

Manager of Capture Planning – Medicaid
– Requirements

• Bachelors degree in Business Management, Healthcare Admin
• Masters degree preferred
• 5+ years of experience in management consulting, managed care, public health industry, or health insurance
• Medicaid experience is highly preferred

Compensation will range to $140,000 + 15% bonus and 25 days PTO

Job Type: Full-time

Pay: $110,000.00 – $140,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Flexible schedule
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Supplemental Pay:

• Bonus pay

Education:

• Bachelor’s (Preferred)

Experience:

• Market Strategy: 5 years (Preferred)
• Business Development: 5 years (Preferred)
• Medicaid: 1 year (Preferred)
• Market Intelligence: 1 year (Preferred)
• Capture Planning: 1 year (Preferred)
• RFP: 1 year (Preferred)

Work Location:

• Fully Remote

Clipped from: https://www.indeed.com/viewjob?cmp=firstPRO-Inc.&t=Manager+Capture+Planning&jk=ba95f0ac8c590dcb&sjdu=QwrRXKrqZ3CNX5W-O9jEvYm9ZmF3VsESfMscwVfGfu2OhkHVhYCT7jH5dgEH0k4I196uMobKJgGTjJaY1dl3yk85Mq8pXdJVCs-8cT6S9QOsYN8F_5_jlUYzEVERnxggMdC73E95dbxQ0TN8qtasLw&tk=1eplnstcsu3mj800&adid=225327490&ad=-6NYlbfkN0CUiNPx3JJMftrniD84mdXKaxJ3iSjJgJAqzFniN-7X5qfIIbgtbL2t4OMTou7BWJfZpB9bHsw7jwCkZWx4jCHgzV36J8UiY5ebqBTocT9S7cUGiYSc-zI929VialFe-FPMmWakBhGbg4V7yrHH-LkGbegF4guGlifV2ngIYGBvSt8yBBdhfOpFPXf-3NMaEwgEaTLJ6p3PRxUKftG329l07myz5ahidDkl_-67kFj5BuYgcONiULZ27fCFBpAUYPm59wnyHvakZR3_zkMSjTuYVuPPJIZnidVe-m0SJnV1sJpB7sVL5ET_hBAPjYAQ8YMVqtZf_CsQc_sEpzrAItem&pub=4a1b367933fd867b19b072952f68dceb&vjs=3

This position is accountable for the day-day development and management of financial models and performance as it relates to business goals and objectives. This position will work with key leaders to ensure that the business is operating effectively, with sound financial analysis, and with appropriate financial and operating controls in place.

Primary Responsibilities:

• Provide monthly financial reporting of key business initiatives
• Provide ongoing financial analysis of development and operational results against the budget
• Work side-by side with the Business Team and/or Finance personnel within OptumHealth and/or across other aspects of UnitedHealth Group, to fully understand the business and support the financial goals and objectives
• Develop and implement controls to support these goals/objectives as needed
• Provide analysis and support for developing ideas, programs and projects
• Develop systems for key financial and operating initiatives, as needed, as business growth occurs and matures
• Directly supervise key financial operating personnel as required; effectively support and promote the development of staff as required
• The Indiana Market CFO will generate forecasts and analyze trends in sales, SG&A, provider performance, product line profitability, membership, medical costs, premium yields, and other areas of the business
• The presents monthly, quarterly, annual operating results with findings and recommendations to internal stakeholders; and prepares health plan budgets and related analysis in conjunction with centralized support areas
• Member of the health plan’s senior leadership team
• Establishes and cultivates a strong relationship with the financial leaders in the state
• Provides comprehensive balanced advice on finance policies
• Frequently interacts with senior leaders, inside and outside the organization, to influence those leaders to adopt new ideas, products, and/or approaches
• Manages and thoroughly monitors strategic projects that have an impact inside and outside of finance
• Entrepreneurial approach to developing innovative solutions to meet customer/business needs
• Provides leadership to and is accountable for the performance and direction through multiple layers of management and senior level professional staff; work most often impacts a large business unit, or multiple markets/sites
• Develops and executes strategies that span a large business unit
• Directs others to resolve business problems that affect multiple functions or disciplines
• Product, service or process decisions are most likely to impact multiple functions and/or customer accounts (internal or external)
• Contributes to the development of business strategy

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:

• Undergraduate degree in Finance, Accounting or equivalent field
• 8+ years of broad experience in multiple Finance disciplines
• Advanced knowledge of Health Care industry (2+ years minimum of Healthcare finance experience)
• Experience reporting to Executive Leadership in a strategic partnership capacity
• Ability to complete complex projects influence change in complicated, fast paced, matrix environment
• Strong working knowledge of financial systems, statements and reports
• Demonstrated success partnering with, leading and influencing multiple teams responsible for complex operations
• 3+ years of managerial and leadership experience of a broad spectrum of professional finance staff (e.g. accounting, medical analysis, financial analysis, budgeting, actuarial, underwriting, etc.)
• If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders

Preferred Qualifications:

• MBA or CPA
• Medicaid and/or Medicare experience

Clipped from: https://www.indeed.com/viewjob?jk=22cae2437f8171c2&tk=1eplnstcsu3mj800&from=serp&vjs=3

Senior Medicaid Datawarehouse Analytics SME

Are you a Medicaid Management Information System (MMIS) subject matter expert with technical/functional Medicaid Data Analytics experience? Do you want to help us transform the Medicaid market as it embraces modularization and we help our clients create a new future for Medicaid technology?

Work you’ll do

Provide expertise on Medicaid and Healthcare Analytics

Lead and manage project teams for both onshore and offshore efforts, manage and lead client facing discussions

Implement data warehouse for a States Medicaid agencies

Design, analyze, support and develop data warehouse objects, data quality processes, design and develop fact and dimension tables, logical and physical database design, data modeling, reporting objects and ETL processes.

Liaison with technical Subject Matter Experts (SMEs) on functional requirements, issues, and decisions

Work on project financials and engagement ergonomics

Perform Data analysis and profiling

Interpret the rules for data integration and conversion

Drive client conversations around technical and functional design and specifications.

Work in Cloud based environment (AWS or Azure )

Implement technology-enabled business solutions for clients as part of a high-talent team.

The team

Our Health Technology team implements repeatable solutions to solve our government clients’ most critical health technology related issues. We advise on, design, implement and deploy solutions focused on government health agencies “heart of the business” issues including claims management, electronic health records, health information exchanges, health analytics and health case management.

Our clients seek a fresh perspective on how to leverage reusable, interoperable and flexible solutions that will enable them to reduce costs, improve health outcomes and respond to public health crises. Professionals will use their deep health, government and technology consulting experience to strategically help solve our client’s technology challenges.

Qualifications

Required:

8+ years of experience.

Bachelor’s degree

MMIS experience

Desired:

Experience within Medicaid Management Information systems (MMIS), Medicaid or Commercial Health Care claims, Provider Management and/or Eligibility data

Experience implementing a data warehouse for State Medicaid Agency

Experience with one of more of the following: SQL/PLSQL, ETL, Cognos, R, Python, Tableau, QlikView, Power BI, Business Objects

Experience in designing, analyzing, supporting and developing data warehouse objects, data quality processes, fact and dimension tables, logical and physical database design, data modeling, reporting process metadata and ETL processes.

Experience working in Cloud based environment (AWS or Azure)

Healthcare Data Analytics

Oral and written communication skills, including presentation skills (MS Visio, MS PowerPoint

PMI Certification

Ability to travel

Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future

How you’ll grow

At Deloitte, our professional development plan focuses on helping people at every level of their career to identify and use their strengths to do their best work every day. From entry-level employees to senior leaders, we believe there’s always room to learn. We offer opportunities to help sharpen skills in addition to hands-on experience in the global, fast-changing business world. From on-the-job learning experiences to formal development programs at Deloitte University, our professionals have a variety of opportunities to continue to grow throughout their career. Explore Deloitte University, The Leadership Center.

Benefits

At Deloitte, we know that great people make a great organization. We value our people and offer employees a broad range of benefits. Learn more about what working at Deloitte can mean for you.

Deloitte’s culture

Our positive and supportive culture encourages our people to do their best work every day. We celebrate individuals by recognizing their uniqueness and offering them the flexibility to make daily choices that can help them to be healthy, centered, confident, and aware. We offer well-being programs and are continuously looking for new ways to maintain a culture where our people excel and lead healthy, happy lives. Learn more about Life at Deloitte.

Corporate citizenship

Deloitte is led by a purpose: to make an impact that matters. This purpose defines who we are and extends to relationships with our clients, our people and our communities. We believe that business has the power to inspire and transform. We focus on education, giving, skill-based volunteerism, and leadership to help drive positive social impact in our communities. Learn more about Deloitte’s impact on the world.

Recruiter tips

We want job seekers exploring opportunities at Deloitte to feel prepared and confident. To help you with your interview, we suggest that you do your research: know some background about the organization and the business area you’re applying to. Check out recruiting tips from Deloitte professionals.

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Clipped from: https://www.indeed.com/viewjob?jk=db6bcee5baf5330b&tk=1eplnstcsu3mj800&from=serp&vjs=3

Oversee and direct all population health functions for the assigned business unit based on, and in support of the company’s strategic plan.

• Lead complex projects including affordability analyses around medical and pharmacy expense, business analysis, documentation of business requirements, and defining current/future scope of work.
• Create and manage clinical affordability projects with internal partners, including but not limited to pharmacy, other clinical and network affordability teams, and pilots.
• Create innovative solutions and process enhancements to drive financial and quality success.
• Lead Clinical Model development and process support for the program in all approved state regions to align with the Clinical Model and meet the requirements for the program by supporting reports , technology and core team.
• Identify trends between Consumer Assessment of Healthcare Providers and Systems (CAHPS) and Member Engagement; create programs/pilots to improve engagement with strategic partners.
• Establish the organizations focus and direction regarding models of care that incorporate needs of all lines of business, focusing on quality and operational efficiencies across the organization.
• Create and measure business and clinical outcomes with respect to the provision of clinical support for practice transformation and successful transition of practice to shared savings/risk contract.

Apply

Clipped from: https://www.indeed.com/viewjob?jk=a6bc5c527e6dd58a&tk=1eplo1k6qu3u4801&from=serp&vjs=3

Education/Experience:

Medical Doctor or Master’s degree in Nursing, Therapy, Pharmacy, Public Health/Administration or related field. MBA preferred. 8+ years of clinical experience in the Healthcare industry. Broad understanding of HEDIS and how it is used to drive business growth and efficiencies. Ability to develop, execute and improve clinical programs across large or multiple business units. Ability to identify, create and tracking clinical program opportunities for population health management. Prior experience in an innovation field, long term project, or evidence of driving successful clinical practice innovative solutions.


Licenses/Certification: Unrestricted license as MD, DO, PA, PT, OT, ST, RpH or PN in NC.


For WellCare of North Carolina Health plan: Individual responsible for providing oversight and leadership of all prevention/population health, care management and care coordination programs, including Local Care management plan, AMH model and care management delivered by Local Health Departments. Must reside in North Carolina; More than 5 years of demonstrated care management/population health experience in a large healthcare corporation serving Medicaid beneficiaries; NC licensed clinician (e.g. LCSW, RN, MD, DO).


Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Serve as a liaison to state government entities to improve the legislative and regulatory environment for the state health plan and Centene Corporation

• Assist with the development of state legislative public policy concerning state insurance, Managed Care Organization and Medicare and Medicaid regulations through the initiatives of state legislators and their staff
  
  
• Develop strategic relationships with state legislative policymakers to enhance the health plan and Centene’s role as a partner with the state and to assist in shaping public policy initiatives
  
  
• Identify, evaluate and analyze the impact of state legislative and regulatory issues for state health plan and Centene Corporation and advise management concerning their impact
  
  
• Represent and serve as point person for the state health plan and Centene Corporation to outside trade groups/stakeholders including state AHIP organization, state medical association, state hospital association and related Medicare and Medicaid business vendors
• Represent state health plan and Centene Corporation to state legislators and their staffs
  
  
• Develop and shape legislative policies and strategies through relevant coalitions and issue advocacy campaigns
  
  
• Balance reporting requirements to multiple constituencies including; Centene Corporation regional vice president, state health plan president, chief operating officers and Corporate regulatory and government affairs staff

Clipped from: https://www.indeed.com/viewjob?jk=617fc81fd8835019&tk=1eplo1k6qu3u4801&from=serp&vjs=3

Position Purpose:

Education/Experience:

Bachelor’s degree in Public Policy, Government Affairs, Business Administration or equivalent experience. Master’s or Law degree preferred. 5+ years of related experience. Extensive knowledge of state legislative and regulatory processes. Experience with state legislature, health care trade associations including America’s Health Insurance Plans (AHIP), National Association of Insurance Commissioners (NAIC) and federal and state Medicare and Medicaid laws and regulations. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.


Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law..

The Coalition for Behavioral Health is at the forefront of advancing a robust agenda for behavioral health in New York City and State. The Coalition provides our member agencies mental health and substance use services throughout New York. We serve New York’s behavioral health community by providing policy, advocacy, training, and technical assistance to more than 100 community-based behavioral health providers.

Clipped from: https://www.indeed.com/viewjob?cmp=New-York-HR-Management-Services-LLC&from=iaBackPress&jk=18bf8f2a5170dacf&q=Medicaid&t=Associate%20Director&vjs=3

Summary:

The Associate Director of Policy & Advocacy will work on the Coalition’s Policy & Advocacy team to advance the Coalition’s agenda in the City and State. The individual will be required to work on critical health policy issues, including the mental health impacts of COVID and the opioid overdose crisis. This position reports to the Director of Policy & Advocacy.

Principal Responsibilities:

· Develop regulatory strategy on Medicaid, in partnership with the Director of Policy & Advocacy

· Lead strategy on one of the following key behavioral health policy areas: children, older adults, supportive housing

· Cultivate relationships with key government officials and member agencies

· Testify at hearings and represent the Coalition at external meetings

· Lead at least one Coalition committee, working with member leadership to develop an agenda create compelling meetings and ensure member engagement

· Write white papers, bill memos, regulatory comments, and other policy materials

· Collaborate on the development of overall strategy agenda and policy priorities

· Expected to work effectively independently and as part of a team

· Other duties as assigned

Qualifications and/or Skills:

· Knowledge of behavioral health and health policy, ideally with expertise in one of the following areas: children, older adults and/or supportive housing

· Ability to build relationships with external stakeholders

· Excellent writing skills

· Familiarity with city and state policymaking process

· Willingness to register as a lobbyist

Education and Experience

· Bachelor’s degree in a relevant field; master’s degree preferred

· At least five years relevant experience

· Previous regulatory policy experience, either in government or at an advocacy organization

Benefits

The Coalition offers a competitive salary and benefits including a pension plan, health, dental, vision and life insurance, STD/LTD, paid vacation and sick leave, and other benefits

EOE

The Coalition for Behavioral Health is an Equal Opportunity Employer and offers equal opportunities for employment for all qualified applicants consistent with federal, state, and local laws.

Job Type: Full-time

Pay: $65,000.00 – $85,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Disability insurance
• Flexible schedule
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Retirement plan
• Vision insurance

Schedule:

• Monday to Friday

Company’s website:

• www.coalitionny.org

Work Remotely:

• Yes

COVID-19 Precaution(s):

• Remote interview process