Principal Government Programs (State Medicaid)

MedImpact•San Diego, CA

1d•$101,277 - $177,234

About The Position

The Principal, Government Programs represents MedImpact’s Government Program and Services Department to key government customers and prospects. Leveraging past experiences, this position establishes and builds solid work relationships with MCO and State fee for service (FFS) executive and operational leaders. Acts as the enterprise lead Subject Matter Expert (SME) in Medicaid, Medicare/Medicaid (MMP) and Marketplace plans for assigned regions. Reviews and interprets current and future policies, develops relationships as necessary with state, federal, and regional stakeholders for purposes of educating oneself and internal staff members. Participates in enhancing existing enterprise strategies, business development opportunities, products and services relative to MedImpact’s Medicaid, Medicaid/MMP and Marketplace lines of business based on impending public policy changes and other market demands.

Requirements

Bachelor’s degree (or equivalent combination of education and experience); Advanced degree preferred ( Ph.D., MBA, M.S., MPA, MPH).
10+ years’ progressive experience in a healthcare related Managed Care Organization and/or State Agency including 8 years as a subject matter expert.
Must have in-depth knowledge of governmental programs (CMS, Medicaid, Medicare, and Market Place/Public Exchanges).
4 years of supervisory experience required. Supervisory experience may be substituted with 5 years of MedImpact experience plus an external leadership training program and internal mentorship with a seasoned leader (VP+ level) that must completed within the first 12 months in the new position.
Solid computer skills with Microsoft Office/Outlook, industry-related databases and use of the internet.

Nice To Haves

Prior work experience within the Centers for Medicare and Medicaid Services (CMS) a plus.

Responsibilities

Participates in the development and implementation of short and long term strategies in order to gain access to prospective MCO and State leadership for purposes of improving the prospect’s knowledge of MedImpact’s differentiated products and services, as well as MedImpact’s proven capability to manage drug spend.
Drives networking activities; participates in conferences, speaking opportunities, state-specific Medicaid leadership meetings.
Participates in the development and implementation of short and long term strategies to increase new government program business.
Maintains awareness of current and future industry trends, including the regulatory environment, customer needs, opportunities and issues. Transforms knowledge into results-generating strategies and business development plans.
Supports the sales process for all Medicaid, MMP and Marketplace MCOs, actively participates in prospect meetings and best and final presentations.
Serves as the key MedImpact SME for Medicaid, MMP and Marketplace, utilizing a deep understanding of these programs as they relate to prescription drug benefit management.
Represents MedImpact to key government customers regarding policy information while working closely with corporate compliance to ensure consistent application of law, rules and regulations relative to program development and deployment.
Meets with assigned clients on a routine basis to review regulatory changes and associated MedImpact solutions and support. Ensures an effective, positive representation of the corporate image.
Maintains a thorough understanding of MedImpact’s programs and services provided to Medicaid, MMP and Marketplace customers. Provides direction on the potential impact of new or potential regulatory requirements relative to these business lines.
Works closely with key business units to review complex regulatory and legislative issues that may impact MedImpact’s business services and operational processes.
Works with Government Programs & Services management to provide information on business requirements of potential program or business development opportunities that align with both client and MedImpact business goals, specific regulated program objectives, performance metrics and financial goals.
Reviews new and pending legislation and regulatory materials relative to Medicaid, MMP and Marketplace with an emphasis on prescription drug management.
Builds strong customer, industry consultant and vendor relationships. Develops relationships with federal and state agencies and other key stakeholders