Director II Medicaid State Operations-Indiana State Health Plan

Elevance Health • Indianapolis, IN

1d • Hybrid

About The Position

Director II Medicaid State Operations This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Reporting directly to the Indiana Medicaid Health Plan President, our Director II Medicaid State Operations will be responsible for responsible for fiscal and operational management of state regional Health Plans. This critical role ensures operational excellence, and efficient execution of our health plan’s strategic initiatives. The ideal candidate will expertly juggle planning, strategy, business change management, and executive support. This position will work in a hybrid way from our corporate offices in Indianapolis. How will you make an impact: 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.

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.

Nice To Haves

• Extensive experience in clinical and operational divisions of a Health Plan Business strongly preferred.
• Deep relationships externally as well as within Elevance Health Ecosystem as it relates to the health plan business strongly preferred.

Responsibilities

• 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.

Benefits

• We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

What This Job Offers

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