Director II Medicaid State Ops
Elevance Health

Job Info

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Director II Medicaid State Operations

Location: This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.

The Director II Medicaid State Operations is responsible for fiscal and operational management of Health Plan various lines of business (Medicaid and Florida Healthy Kids).

How you will make an impact:

• Develops, directs, plans, and evaluates the goals and objectives of the Health Plan. Along with State CEO, 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.
• Will assist the CEO for oversight and problem solving for Health Plan contractual operations which may include, 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.
• Responsible for oversight and direction of operational team who handles claims, configuration and provider payment resolution.
• Leads and manages the local Health Plan performance management/operating gain improvement activities.
• Develops short- and long-term strategies and objectives for contract operational compliance.
• Hires, trains, coaches, counsels, and evaluates performance of direct reports.

Minimum Requirements:

• 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, Capabilities, and Experiences:

• Master's degree preferred
• Travel maybe required up to 10% monthly

For candidates working in person or remotely in the below location(s), the salary* range for this specific position is $166,796 to $250,194.

Locations: New Jersey

In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company

is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.

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