Director, Medicaid Healthcare Services Solutions

This position is Flexible and the individual may reside in any KP authorized state including California, Oregon, Colorado, Washington, Hawaii, Georgia, Maryland and Washington DC.

*
* PLEASE NOTE:

Salary ranges are geographically based and the posted range reflects the Northen CA region. Lower salary ranges will apply for other labor markets outside of NCAL

Director of Medicaid Health Care Services Solutions plays a critical role in the Medicaid Line of Business to ensure all Medicaid programs meet state regulatory requirements and align with National Medicaid Care Model.

This position reports to the Sr. Director of Medicaid Solutions and focuses on developing and managing the execution of the solution roadmap for Health Care Services related solutions in partnership with our IT, informatics and data analytic partners. Solutions focus on functional areas such as Care Coordination / Care Management, Utilization Management, Population Health Management, and Quality.

This role will interface with Market operational and Permanente Medicaid Group partners to focus on Medicaid specific benefits and programs. The objective is to maximize regulatory compliance while improving member care experience and operational performance.

Oversees and directs a team of consultants to ensure the alignment, buy-in, and coordination of diverse stakeholders to drive successful initiatives and projects within clinical settings across one or more technical areas or work streams. Oversees and drives the development and implementation of complex clinical initiatives, systems, and processes to a desired future state. Drives the development of clinical or care delivery strategy and ensures organizational alignment and prioritization of clinical initiatives by developing and determining goals and priorities with management team sponsors;

defining, developing, and evaluating performance metrics. Oversees the management of complex, highly visible projects or project components, oversees large and complex change management activities, and directs team members in performing complex data analyses to drive care delivery or clinical initiatives. Oversees vendor management as required. Monitors and takes accountability for compliance of team work activities by ensuring business plans and team members adhere to relevant policies and procedures.

• Prepares individuals for growth opportunities and advancement; builds internal collaborative networks for self and others. Solicits and acts on performance feedback; drives collaboration to set goals and provide open feedback and coaching to foster performance improvement. Demonstrates continuous learning; oversees the recruitment, selection, and development of talent; ensures performance management guidelines and expectations to achieve business needs. Stays up to date with organizational best practices, processes, benchmarks, and industry trends;
  
  shares best practices within and across teams. Motivates and empowers teams; maintains a highly skilled and engaged workforce by aligning resource plans with business objectives. Provides guidance when difficult decisions need to be made; creates opportunities for expanded scope of decision making and impact.
• Oversees the operation of multiple units within a department by identifying member and operational needs; ensures the management of work assignment completion; translates business strategy into actionable business requirements; ensures products and / or services meet member requirements and expectations while aligning with organizational strategies. Gains cross-functional support for business plans and priorities; assumes responsibility for decision making; sets standards, measures progress, and fosters resolution of escalated issues.
  
  Communicates goals and objectives; analyzes resources, costs, and forecasts and incorporates them into business plans; prioritizes and distributes resources. Removes obstacles that impact performance; guides performance and develops contingency plans accordingly; ensures teams accomplish business objectives.
• Oversees and directs a team of consultants to ensure the alignment, buy-in, and coordination of diverse stakeholders to drive successful initiatives and projects within care delivery or clinical settings across one or more technical areas or work streams by providing leadership to high visibility projects to identify and resolve issues of strategic importance to the organization; ensuring representation and inclusion of appropriate stakeholders and team members;
  
  building rapport and partnerships with stakeholder teams, third party vendors, and senior/executive management to produce results that are outcome driven; partnering with lead stakeholders to set the strategic direction of initiatives, develop goals and set the prioritization of deliverables; driving key processes (e.g. quality management, project change management, communication) and facilitating decisions necessary for the…