Director, CHIP Programs - JHP

Job Details

The Director of CHIP Programs is a senior leadership role responsible for driving the company’s regulatory, policy and growth strategy across a complex and rapidly evolving healthcare landscape. This position demands a deep and comprehensive understanding of federal and state regulatory frameworks governing the CHIP program. The Director will lead the CHIP policy strategy to ensure the company not only meets but anticipates regulatory requirements, leverages growth opportunities and competitive positioning, and minimizes risk while enabling strategic business growth and innovation.

As a key member of the policy and regulatory affairs leadership team, the Director will influence policy interpretation, regulatory submissions, and cross-functional alignment. The Director will lead strategic development of CHIP growth strategy and direction, driving new and innovative policy solutions that will advance growth in the CHIP line of business. This role requires a visionary leader who can manage, mentor, and inspire a high-performing team of policy and regulatory professionals, fostering a culture of accountability, continuous learning, and proactive problem-solving. The Director will serve as the authoritative voice on CHIP policy matters, cultivating strong relationships with regulators, industry stakeholders, and internal partners to navigate regulatory complexities effectively and strategically position the company in the marketplace.

Job Description

Strategic Leadership

• Develop and execute comprehensive policy and regulatory strategies to both ensure full compliance with CHIP program requirements and advance long-term growth and sustainability goals for the CHIP line of business.
• Identify opportunities for enrollment growth, improved quality performance, and integration with provider system initiatives.
• Use market intelligence and policy insights to anticipate changes in the CHIP landscape and position the plan for long-term success.
• Implement strong project management and governance structure to drive forward cross-functional tactics that will position the CHIP line of business for long-term success.
• Develop and maintain an actionable, measurable ongoing annual strategy for growth and retention of CHIP members, working collaboratively to translate policy ideas into operational implementation.

Policy Analysis & Strategy

• Conduct in-depth analysis of state and federal CHIP policy trends, funding mechanisms, and program reforms.
• Advise executive leadership on strategic implications of regulatory developments, including potential impacts on rates, benefits, eligibility, and enrollment.
• Align CHIP policy strategy, where appropriate, with the parent delivery system’s goals and value-based care initiatives.
• Collaborate with legal, compliance, and operational teams to mitigate regulatory risk and address findings.
• Monitor regulatory developments at CMS, state CHIP agencies, the Centers for Medicare & CHIP Services, and the Department of Health and Human Services that impact these programs.
• Maintain Oversight of policy and regulatory intelligence and key regulatory communications including risk assessment governance.
• Implement direct end-to-end contract and program administration including review and approval of marketing materials and mandated member communications. 
• Lead regulatory submissions for the CHIP line of business
• Collaborate with product development, actuarial, legal, and compliance teams to align regulatory requirements with benefit design and operations.

Government and Stakeholder Engagement

• Serve as the primary liaison with state regulators, representing the plan in collaboration with the Chief Growth Officer in policy discussions, rate-setting processes, and contract negotiations.
• Represent Jefferson Health Plans in all state and federal associations and partnerships.
• Build strong relationships with state officials, community-based organizations, and other external stakeholder groups that impact the CHIP line of business
• Represent the plan as needed at industry forums, workgroups, and coalitions related to CHIP health coverage.
• Serve as the primary point of contact for federal and state regulatory agencies regarding CHIP policy and regulatory issues.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Competencies (Knowledge, Skills, and Abilities Required):

• Experience with CHIP managed care plans or state government.
• Familiarity with state CHIP waiver and procurement processes and program implementation.
• Strategic mindset with ability to anticipate regulatory