Director Medicaid Product & Market Development

Company :

United Concordia Dental

Job Description : 

JOB SUMMARY

This job is responsible for the United Concordia Dental Medicaid business and growth strategy, product management and innovations, provider network designs, and strategic execution of our growth initiatives, ensuring successful implementation of new affiliations, markets or products. Development of the overarching strategy and leading the organization through market entry, product and network design, regulatory approval, and transition to market operations to realize member growth and financial success. Collaborate with all relevant functions within the organization and vendor partners to build comprehensive market entry, implementation and integration plans with new Blues plans and/or new Highmark Medicaid plans. Overall responsibility for the implementation strategy of the new business and product opportunities to include regulatory and legal approvals and operational, market and workforce planning. Responsible for the overall effectiveness of the dental Medicaid business strategy and growth opportunities realization.

ESSENTIAL RESPONSIBILITIES

• Perform management responsibilities to include, but are not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.  Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority.
• Responsible for ensuring the overall acquisition and retention of the dental Medicaid business. Provides the strategic leadership in the development and implementation of the dental Medicaid strategy. Works collaboratively with other corporate and functional leaders and individuals throughout the organization.
• Responsible for the relationship management at the state-level with key stakeholders, community leaders and representatives, government agencies, and other governing bodies relating to dental Medicaid business either directly with state agencies or in collaboration with a medical Managed Care Organization.
• Review and approve all materials (product description documents, benefit booklets, contracts, subscription agreements, sales support materials, communications/publications, web materials, etc.) to ensure that these documents support existing product specifications and reflect the current product offering, administration and/or the modifications resulting from new initiatives.
• Other duties as assigned or requested.

EDUCATION

Required

• Bachelor's Degree in related field

Substitutions

• 4 years of related and progressive experience in lieu of Bachelor's degree

Preferred

• None

EXPERIENCE

Required

• 5 years in a Management or leadership role
• 5 years Health insurance, products, sales, pricing, or marketing experience
• 5 years Work in development and acquisition of new business

Preferred

• 5 years Medicaid or comparable federal and state government health programs experience
• 5 years Strategic planning and/or execution management experience
• 5 years Business Management Information Systems experience
• 5 years Project portfolio, program and project management Provider network and reimbursement management experience
• 5 years Vendor management experience
• 5 years Quality and process improvement experience

LICENSES or CERTIFICATIONS

Required

• None

Preferred

• None

SKILLS

• Must possess a high level of skill in dealing with others in the organization, including excellent presentation and negotiation skills.
• Creativity necessary to envision future products, and how consumers will relate to those products.
• Ability to direct and manage Corporate-wide activities. 
• Experience managing professional staff and familiarity working within a wide variety of health care, financial, research, administrative, and communication disciplines
• Analytical 
• Collaboration
• Communication Skills
• Cross-functional Team Leadership
• Influence and Persuasion
• Problem Solving & Decision Making

Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-based

Teaches / trains others regularly

Frequently

Travel regularly from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Yes

Lifting: up to