Location: This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.
The Director II Medicaid State Operations is responsible for fiscal and operational management of Health Plan various lines of business (Medicaid and Florida Healthy Kids).
How you will make an impact:
Develops, directs, plans, and evaluates the goals and objectives of the Health Plan. Along with State CEO, establishes overall standards, policies and objectives for Health Plan in accordance with applicable regulatory requirements; ensures alignment and support with overall Medicaid Business Unit mission, goals and objectives.
Will assist the CEO for oversight and problem solving for Health Plan contractual operations which may include, local marketing and community relations, network development, provider partnerships, provider relations, medical management, case management and quality management programs, performance management/improvement, budgets, complaints and appeals, regulatory and contractual compliance, monthly financials, and reporting.
Responsible for oversight and direction of operational team who handles claims, configuration and provider payment resolution.
Leads and manages the local Health Plan performance management/operating gain improvement activities.
Develops short- and long-term strategies and objectives for contract operational compliance.
Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Minimum Requirements:
Requires a BA/BS in a related field and minimum of 8 years relevant experience, including in-depth experience in the HMO/healthcare field, minimum of 5 years working with Medicaid and/or Medicare programs; or any combination of education and experience, which would provide an equivalent background.
Preferred Skills, Capabilities, and Experiences:
Master's degree preferred
Travel maybe required up to 10% monthly
For candidates working in person or remotely in the below location(s), the salary* range for this specific position is $166,796 to $250,194.
Locations: New Jersey
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company
is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
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 elevancehealthjobssupport@elevancehealth.com for assistance.
