Job Information
Elevance Health Dir II Medicaid State Ops in METAIRIE, Louisiana
Location: This position will work a hybrid model and must reside within 50 miles of our Metairie, LA location at 3850 N CAUSEWAY BLVD.
Responsible for fiscal and operational management of state regional Health Plans.
Primary duties may include, but are not limited to:
Develops, directs, plans, and evaluates the goals and objectives of regional area within a State Health Plan.
Along with State CEO and COO, establishes overall standards, policies and objectives for Health Plan in accordance with applicable regulatory requirements; ensures alignment and support with overall Medicaid Business Unit mission, goals and objectives.
Responsible for local marketing and community relations, network development, provider partnerships, provider relations, medical management, case management and quality management programs, performance management/improvement, budgets, complaints and appeals, regulatory and contractual compliance, monthly financials, and reporting.
Resolves complex financial, legal, or politically sensitive issues.
Leads program development to ensure members, network providers, and community partners successfully participate.
Leads and manages the local Health Plan performance management/operating gain improvement activities.
Develops short and long term marketing and retention strategies and objectives. Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Minimum Qualifications:
- Requires a BA/BS in a related field and minimum of 8 years relevant experience, including in-depth experience in the HMO/healthcare field, minimum of 5 years working with Medicaid and/or Medicare programs; or any combination of education and experience, which would provide an equivalent background.
Preferred skills, qualifications and experiences:
- Masters degree preferred.