Director, Medicaid Programs

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Job Description:

The Director, Medicaid Programs leads and is accountable for all facets of the Regional Accountable Entity (RAE) contract by Colorado Community Health Alliance (CCHA) with the Colorado Department of Health Care Policy & Financing (HCPF). Reporting to the Vice President, Government Programs, the Director will provide subject matter expertise to for CCHA’s execution of the goals of the Accountable Care Program (ACC). The role will lead day-to-day operations of CCHA as well as support strategy development to ensure the delivery of comprehensive, cost-effective, quality care that improves the Health First Colorado (Colorado’s Medicaid Program) Member and Provider experience. As Director, this role will serve as CCHA’s spokesperson to HCPF, other state agencies, providers, stakeholders and community organizations. Demonstrated experience working with primary care and behavioral health providers is required. Impeccable presentation and written communication skills are required. Position may include evening hours and travel throughout the eight-county area of CCHA.

Essential Functions:

• Serves as internal and external spokesperson for CCHA, including conducting presentations and media interviews.
• Responsible for partnering with internal business and joint venture partners to achieve strong readiness performance and a successful RAE implementation.
• Mutually defines success of CCHA with internal business partners to implement tactical strategies that help to achieve success of the RAE.
• Adapt, develop and/or revise policies and procedures and promote their implementation across the organization.
• Maintains a healthy partnership with the state to meet all readiness requirements prior to implementation and meet contract expectations, with an emphasis on high-quality deliverables, strong audit performance and a collaborative relationship with the state.
• Responsible for oversight to ensure all contractual requirements are delivered to the state on time and in a consistent and accurate manner (across all stakeholders).
• Works with joint venture partner to meet RAE contract requirements and ensure adherence to state and federal regulations.
• Serves as ACC subject matter expert for providers, partners and the community.
• Manages Medicaid Programs consisting of team members dedicated to the administration and operations of the contract; this includes budget and staffing.
• Responds to inbox, web form, phone and voicemail while meeting required inbound and outbound call and email response times.
• Adheres to the company’s Compliance Program and to federal and state laws and regulations
• Other duties as assigned

This position is a full-time Hybrid role. Our business hours are Monday – Friday, 8am-5pm

Travel: Up to 30% in region and in office expectations at least four times a month.

Knowledge, Skills and Abilities:

• Knowledge of provider office workflow processes, healthcare delivery systems and healthcare trends
• Healthcare experience and knowledge of healthcare terminology, specifically related to Medicaid and value-based care.
• Strong facilitation skills for small and large group engagements.

• Excellent communication and interpersonal skills (verbal and written) necessary to effectively interact with all levels of the organization and external entities.
• Able to juggle multiple projects that greatly differ in subject matter while exceling in time management and organization.
• Comfort using project management tools for managing performance and tasks.
• Remain flexible in work schedule to provide the most effective and efficient support for the organization and practices.

• Proficient in Microsoft Office Suite.
• Position may require working outside of normal business hours at times.

Qualifications:

• Bachelor’s degree, or equivalent; or ten years related experience and/or training; or equivalent combination of education and experience. Graduate degree preferred (MBA, MPA, MPH, MHA).
• Minimum of six to eight years progressive experience in managed health care, including provider contracting, provider relations, and the implementation of strategies and tactics; or any combination of education and experience, which would provide an equivalent background.
• Five to seven years direct Medicaid experience.
• Knowledge of the principles and practices of health planning and management sufficient to manage, direct and coordinate the o