Senior Market Development Professional - Kentucky Medicaid

## Senior Market Development Professional - Kentucky Medicaid Apply locations:
Louisville, KY:
Remote Kentucky time type:
Full time posted on:
Posted Todayjob requisition :
R-421647#
** Become a part of our caring community
** The Senior Market Development Professional supports Kentucky Medicaid product implementation, operations, contract compliance, and regulatory deliverables. You will lead operational oversight support, including meeting preparation, action tracking, and execution of strategic initiatives. You will use regulatory and operational data to drive insights, align reporting, and ensure follow-through across all associated work streams to ensure health plan compliance. Drive process improvement to ensure health plan efficiencies and best practice implementation.

Critical position requirements:
* Market oversight and monitoring:
Market oversight and monitoring of required contractual processes. Initiate escalation/tickets with business areas/work streams for analysis and correction. Provide regulatory, contractual and procedural guidance.
* Operational process improvement:
Document, maintain, and improve core Market Operations processes; update procedures as needed and support implementation of new projects.

Additionally, you will strengthen market execution across:
* Data Analysis and Reporting:
Interpret regulatory/operational data and partner with Data & Reporting to produce insights that inform market strategy and leadership decisions.
* Cost of Care Realignment:
Coordinate meetings, manage deliverables, and track implementation of cost-saving initiatives.
* Market Oversight and Compliance:
Track market oversight activities and drive closure of compliance actions and process improvements.
* Kentucky Medicaid Operations Oversight Meeting Management:
Develop agendas, coordinate KMOO sessions, and manage post-meeting action items focused on compliance, trends, and consumer experience.
* Consumer Experience Initiatives:
Support Consumer Experience Professional 2 by coordinating assignments and implementing process improvements from call listening sessions.
* Vendor Support:
Coordinate communications and operational changes with vendor management professionals to ensure vendor compliance with Health plan and vendor contract. Ensures implementation of program updates and member/provider communications coordinating through vendor management professionals.
* Regulatory Reporting Alignment:
Ensure alignment between regulatory reports and the KDMS Operations Insights Dashboard for accuracy and transparency.
* Plan Resource Manual:
Maintain the Plan Resource Manual (contacts and processes) to support market execution.#
** Use your skills to make an impact
**** Required Qualifications
*** Bachelor's degree
* 5 or more years of experience in a insurance or health care setting
* 2 or more year's experience interpreting regulations and contracts
* Demonstrated experience implementing and measuring outcomes for complex health-related initiatives/pilots
* Strong relationship-management and stakeholder-influence skills
* Process improvement mindset; ability to document, standardize, and enhance operational workflows
* Commitment to improving consumer experience
** Preferred Qualifications
*** Master's Degree
* Medicaid experience
* PMP certification
* Six Sigma
* Proficient with Microsoft office products
** Additional Information
*** Must reside in KY or surrounding states with the ability to work in the office 2 days a week at minimum.
** WAH Internet Statement
** To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
* At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
* Satellite, cellular and microwave connection can be used only if approved by leadership.
* Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
* Humana will provide Home or Hybrid Home/Office employees with telephone equipment…