Program Director, Medicaid Services (Indianapolis, IN / Hybrid)

FreedomCare•Indianapolis, IN

6d•Hybrid

About The Position

FreedomCare is a healthcare company dedicated to revolutionizing the home care industry since 2016, empowering patients to choose their caregivers. The company supports patients across the U.S. with a mission driven by values of service, ownership, integrity, and positivity. This hybrid role is based in the Indianapolis, IN area, requiring three days a week in the office. The Program Director, Medicaid Services is responsible for the operational, regulatory, quality, service delivery, and growth performance of an assigned state Medicaid program. This role acts as the program's operational subject-matter leader, ensuring person-centered services in compliance with all relevant state and federal requirements, including Medicaid manuals, waiver provisions, provider agreements, managed care requirements, and FreedomCare policies. The Director leads clinical and non-clinical operations, develops policies and workflows, monitors program performance and risk, and ensures audit readiness. Collaboration with Marketing, business development, intake, clinical, compliance, finance, and technology teams is crucial for responsible program growth while prioritizing member health, welfare, safety, choice, and quality of care.

Requirements

Bachelor's degree in healthcare administration, business administration, public health, human services, nursing, social work, or a related field; equivalent relevant education and experience may be considered.
Five or more years of progressively responsible healthcare or Medicaid operations experience, including at least three years in a leadership or program-management role.
Demonstrated experience interpreting and operationalizing regulations, provider manuals, contracts, policies, and audit requirements.
Experience leading clinical and non-clinical teams, managing program performance, implementing corrective actions, and collaborating with compliance, quality, finance, marketing, and technology functions.
Ability to utilize technology to advance company initiatives.
Must be comfortable rolling up their sleeves, being hands-on, and doing whatever is necessary to support the team while building and growing it.
Great interpersonal skills: you’re able to bring people along, inspire them, ask tough questions, and hold people accountable.
An operational mastermind: you have a natural ability to identify processes that work, metrics that tell the story, and operations that scale without sacrificing quality.
A humble leader: you understand that to lead is to set an example, to listen to others, and to always keep learning.

Nice To Haves

Experience with Medicaid-funded home- and community-based services, long-term services and supports, managed care, or another regulated human-services program strongly preferred.
Business development, referral partnership, community outreach, or healthcare marketing experience preferred.
Passion for improving home care and for leveraging technology to improve lives.
Energized by ambitious goals and working in a fast-paced environment.
Master's Degree in healthcare administration or business administration.
5 + years experience with the Structured Family Caregiving (SFC) Medicaid Home Care program in IN.

Responsibilities

Serve as the accountable operational leader and subject-matter resource for the assigned Medicaid program and manage day-to-day program operations in the assigned state and other locations as directed.
Develop and maintain a thorough working knowledge of applicable state statutes, regulations, Medicaid state-plan or waiver requirements, provider manuals, bulletins, contracts, managed care requirements, accreditation standards, and FreedomCare policies.
Monitor regulatory and program changes; assess operational impact; partner with Compliance, Legal, Clinical, and other stakeholders; and implement required changes within established timeframes.
Ensure the program follows applicable federal and state requirements, contractual obligations, member-rights protections, privacy and security requirements, and organizational compliance policies.
Develop, implement, review, and update program-specific policies, procedures, standard operating procedures, forms, tools, training, and internal controls based on regulatory and operational requirements.
Oversee Medicaid program workflows, including referral and intake, eligibility verification, enrollment, service authorization, assessment and reassessment, person-centered service planning, service initiation, monitoring, renewal, transition, and discharge, as applicable to the program.
Ensure services are delivered according to each member's authorization and person-centered plan, including required contacts, visits, documentation, follow-up, and care-team communication.
Protect member health, welfare, safety, choice, dignity, and continuity of care by overseeing risk identification, incident reporting and follow-up, complaints and grievances, emergency and backup planning, and escalation of clinical or compliance concerns.
Oversee clinical and non-clinical teams while ensuring that assessments, clinical judgments, supervision, and signatures reserved for licensed or otherwise qualified professionals are completed by the appropriate personnel.
Hire, onboard, train, coach, and develop program staff; establish clear accountability; monitor workload and caseload capacity; and maintain staffing levels appropriate to member needs and program requirements.
Ensure staff and caregivers meet applicable qualification, screening, background check, credentialing, training, competency, and ongoing education requirements, with complete and current supporting records.
Maintain audit and survey readiness through routine case-record reviews, compliance monitoring, evidence management, corrective action plans, and verification that identified deficiencies are corrected and do not recur.
Establish and monitor program goals, key performance indicators, service-quality measures, member and caregiver experience measures, timeliness standards, and compliance metrics; use findings to drive performance and quality improvement.
Review data for disparities, barriers, adverse trends, missed services, documentation gaps, authorization risks, incidents, complaints, and other indicators requiring intervention or escalation.
Partner with Marketing and business development teams to create and execute a compliant growth strategy, including market education, outreach, referral development, community partnerships, and accurate program messaging.
Review program-specific marketing and outreach activities with appropriate Compliance and Legal partners to ensure communications are accurate, do not misrepresent Medicaid eligibility or benefits, and follow state, contractual, and organizational marketing requirements.
Build and maintain productive relationships with state agencies, managed care entities, case management organizations, referral sources, community partners, members, caregivers, and other program stakeholders.
Partner with intake and operational teams to improve conversion from referral through service initiation, identify barriers to enrollment, and support sustainable census growth without compromising quality or compliance.
Partner with Finance and executive leadership on program budgets, resource planning, staffing investments, financial performance, and responsible stewardship of Medicaid funds.
Partner with Technology and Product teams to improve systems, reporting, data integrity, documentation, and workflows while ensuring that technology supports regulatory and operational requirements.
Lead program implementation and expansion activities, including operational readiness, staffing, training, facilities, systems, community relationships, internal controls, and service-launch planning.
Promote a positive, accountable, inclusive, and collaborative work environment consistent with FreedomCare core values and a commitment to ethical Medicaid service delivery.
Perform other duties and support other states or programs as assigned.