Medicaid State Operations Director

Medicaid State Operations Director-Kansas

Location: Kansas. 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.

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.

The Medicaid State Operations Director-Kansas will be responsible for operations functions, including coordination between internal departments, ensuring the appropriate strategy, tactics, and processes are in place to affect solid organizational operations and oversight.

• Resolves programmatic challenges related to operations including member issues, provider claims issues, contract configuration issues, etc.
• Serves as liaison to Health Plan support services, which could include:
  Claims, Enrollment, NCC, PDM/PDQ, configuration;
  Quality, Regulatory Compliance, IT, Reimbursement policy, etc.
• Identifies opportunities for Operational Excellence and works to create seamless processes between shared services and the Health Plan.
• Develops and implements key operational indicators to be used for monitoring and analysis of the Health Plan operations.
• Serves as a liaison with state regulatory agencies when appropriate.

• Requires a BA/BS in Business, Healthcare Administration, or related field and a minimum of 10 years experience, including a minimum of 8 years in-depth experience in managed care operations; or any combination of education and experience, which would provide an equivalent background.

• Masters degree preferred.
• Six Sigma Black Belt preferred.
• Experience in a highly matrixed healthcare environment.
• Demonstrated knowledge and understanding of Kan Care and regulatory requirements for Managed Care Organizations (MCOs).

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.

Applicants who require accommodation to participate in the job application process may contact elevancehealthj for assistance.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.