Director, Medicaid

Technical Summary:

Reporting to the Senior Vice President of National Medicaid, the market Medicaid line of business leader is responsible for the overall performance of the NW markets Medicaid line of business programs, focusing on financial performance and membership growth. Oversees all aspects of market Medicaid programs, state contracting arrangements, product development, compliance with State and Federal Policies and requirements. Strategically builds, manages and sustains external business relationships, particularly with state and local regulators. Accountable for product development, administrative processes, interdepartmental communication, and regulatory requirements. Develops an annual strategic plan and updates market and National Executive Sponsorship on strategic issues/development, business performance, and progress against objectives. Demonstrated passion and creativity in developing models of care serving low income vulnerable populations.

Summary:

This director level position is responsible for directing strategic, enterprise-wide, cross-regional, and/or multi-disciplinary programs to drive exceptional business value for KP; directing evolving strategic priorities and providing strategic planning within and across programs to ensure alignment and performance across the organization. This includes monitoring the progress of initiatives, proactively identifying risks and opportunities of strategic business value, addressing escalated issues, and overseeing the identification and evaluation of data and key performance drivers to ensure strategy performance. This position involves directing the development of design plans and supporting change management strategies during key program or organizational changes; providing leadership in dynamic situations requiring exceptional consulting, internal influence, conflict management, and resource/team management; driving a “can-do” strategic approach with sound business acumen; and partnering with senior leaders in a fast-paced environment.

Core Responsibilities:

• Prepares individuals for growth opportunities and advancement; builds internal collaborative networks. Solicits and acts on performance feedback; drives collaboration to set goals and provide open feedback and coaching to foster performance improvement. Oversees the recruitment, selection, and development of talent; ensures performance management guidelines align with business needs.

• Oversees the operation of multiple units within a department by identifying member and operational needs; ensures completion of work assignments; translates business strategy into actionable requirements. Communicates goals and objectives; analyzes resources, costs, and forecasts into business plans; prioritizes resources and removes obstacles impacting performance.

Key Responsibilities:

• Directs the delivery of large-scale programs with multiple workstreams and strategic business goals, ensuring program outcomes are achieved from initiation to close-out. Reviews program plans, identifies and manages scope, and supplies appropriate staffing within budget and schedule. Develops processes for organizational change management.

• Directs programs team, overseeing team decisions based on alignment of member skills and program demands. Delivers performance feedback to the team.

• Proactively monitors, identifies, and mitigates program risks across multiple interdependent programs by recommending changes to program processes.

• Ensures program activities adhere to policies by maintaining adherence to KP, departmental, and/or business line policies.

• Directs alignment, buy-in, and engagement of diverse stakeholders to set long-term program goals, building relationships and communicating with internal customers, vendors, and executive management.

• Oversees vendor performance, providing direction for service improvements and directing partnerships and contract negotiations.

Minimum Qualifications:

• Five years experience delivering strategic program management with senior leadership.
• Four years experience in a leadership role with direct reports.
• Three years experience managing operational or project budgets.
• Bachelors degree and twelve years experience in project management or related field, including seven years program management experience, or fifteen years experience in project management or related field including seven years program management experience.

Additional Requirements:

• Knowledge, Skills, and Abilities (KSAs): Change Management, Negotiation, Applied Data Analysis, Financial Acumen, Business Relationship Management, Conflict Resolution, Managing Diverse Relationships, Project Management, Risk Assessment.

Preferred Qualifications:

• Experience in strategic planning, consulting, and/or development, including defining strategies and business benefits.

• Master's Degree in Business Administration or related field.

• Experience in healthcare, delivering presentations to executive management, and working in a matrixed organization.

• Experience with project management and collaboration software.