CCO Operations Director (Health Policy and Program Administrator 1)

State of Oregon • Salem, OR

2d • $9,604 - $14,856 • Hybrid

About The Position

The Oregon Health Authority (OHA) Coordinated Care Organization (CCO) Operations section is responsible for implementing, overseeing, and improving Medicaid policies and operational requirements for CCOs delivering Oregon Health Plan (OHP) physical, oral, and behavioral health benefits. The Director leads development and administration of CCO program policy; oversees the CCO contract; and provides strategic oversight of four key operational units: CCO Quality Assurance, CCO Contracts and Rules, CCO Services, and Claims & Encounter Data Services.
In this position, you will play a critical role in promoting alignment and systemwide integration across managed care and fee for service (FFS) delivery systems, centering its leadership on CCO Operations while collaborating closely with internal and external partners to ensure cohesive and coordinated delivery of the Oregon Health Plan. You will lead strategic planning, systems alignment, legislative strategy, and community and partner engagement efforts that shape the design and delivery of the Oregon Health Plan and the experience of 1.4 million OHP members. You will collaborate with Tribal governments, CCOs, community-based organizations, advocacy groups, health systems, and state and federal partners, and align operational and policy decisions with OHA’s transformation and health equity priorities. You will play an integral part of the Medicaid Division’s Director’s Office and be a key leader in establishing the overall direction and mission of the division.
In this position, you will have the privilege and responsibility to collaborate with diverse populations most harmed by social injustice and inequities and will demonstrate the ability to build and steward positive, collaborative and partnership-based relationships with diverse community groups including communities of color, immigrant groups, the disability and neurodivergent communities, veterans, older adults, individuals identifying as LGBTQIA2S+ and other communities that have been traditionally marginalized.

Requirements

• Five years of management experience; OR two years of management experience and a Bachelor’s degree in a related field.

Nice To Haves

• Experience leading the development and implementation of policies and programs at the community, state, and/or national level that advance health equity (address systemic health disparities, expand culturally responsive and inclusive services, factor in social determinants of health) and elevate the voice of community and those with lived experience.
• Knowledge of health services delivery systems, particularly the Oregon Health Plan, managed care, and Medicaid administration in Oregon, including experience working with Coordinated Care Organizations, social safety net programs, health service providers (including Community Mental Health Programs and other behavioral health service providers), and community-based organizations to guide operations and policies.
• Knowledge of legislative and regulatory processes; experience interpreting, applying and advising on federal and state laws and regulations, as well as legislative concepts/bills; specific knowledge of Medicaid Fee for Service and Managed Care regulations, Oregon Administrative Rules, and Oregon Revised Statutes.
• Knowledge and experience developing, implementing, and refining policies included in the Medicaid state plan or other waiver authorities with Centers for Medicare and Medicaid Services (CMS).
• Familiarity with varying funding streams for statewide and community investment and value-based payment mechanisms.
• Ability to provide organizational leadership to foster inter- and cross-agency collaboration and to shape systems-wide community centered policies, programs, and continuous (performance / quality / process) improvement strategies.
• Experience in effectively managing teams and fostering a trusting team culture.
• Ability to provide financial and budget management, tracking and oversight for larger scale efforts or program / team accountability.
• Ability to navigate complex relationships through collaborative problem-solving, consensus-building, and solution-focused approaches, recognizing positionality and fostering power-sharing dynamics.
• Experience facilitating meetings with a variety of key partners, including internal teams, community members/groups, health service providers, government officials and legislators.
• Experience and knowledge evaluating and synthesizing quantitative and qualitative data to analyze and measure the effectiveness, efficiency, and impact of administrative and technical programs within the context of health policy / healthcare services.
• Experience presenting and articulating the value and relevance of research and evaluation data to facilitate quality assurance, strategic planning, and decision-making.
• Knowledge about contracts/interagency agreement administration, procurement, and grant administration within the context of Oregon state government (e.g. OHA/ODHS) or other complex health services delivery organizations.

Responsibilities

• Leads development and administration of CCO program policy.
• Oversees the CCO contract.
• Provides strategic oversight of four key operational units: CCO Quality Assurance, CCO Contracts and Rules, CCO Services, and Claims & Encounter Data Services.
• Promotes alignment and systemwide integration across managed care and fee for service (FFS) delivery systems.
• Leads strategic planning, systems alignment, legislative strategy, and community and partner engagement efforts.
• Collaborates with Tribal governments, CCOs, community-based organizations, advocacy groups, health systems, and state and federal partners.
• Aligns operational and policy decisions with OHA’s transformation and health equity priorities.
• Establishes the overall direction and mission of the Medicaid Division.
• Builds and stewards positive, collaborative and partnership-based relationships with diverse community groups.

Benefits

• Excellent, low-cost medical, vision, and dental coverage for you and your family.
• Optional benefits like life insurance, disability coverage, deferred compensation, and FSA options for health and childcare.
• Generous paid time off: 11 holidays, 3 personal days, monthly sick leave, and vacation accrual starting at 8 hours/month.
• Potential eligibility for the Public Service Loan Forgiveness Program.
• Retirement security through Public Employees Retirement System (PERS)/Oregon Public Service Retirement Plan (OPSRP).
• Training and development opportunities to grow your career with the State of Oregon.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager