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