Director, Medicaid Network Implementation (Remote Optional)

  • Humana
  • Remote * (Colorado Springs, CO, USA)
  • Jan 15, 2022
Information Technology Management Telecommuting

Job Description

About this job Description The Director, Medicaid Network Implementation is accountable for driving efficient management of network builds and implementations in new Medicaid markets. This position will translate network and provider strategies into tactical plans that can be executed on to ensure timely and successful new market launches. This position will lead a team of associates to direct the timelines, processes, provider data needs, and enterprise readiness to effectively implement network development strategies. Decisions are typically related supporting technical and operational procedures and processes, and implements strategic plans, drives goals and objectives, and improves processes and performance. The Director, Medicaid Network Implementation requires an in-depth understanding of how organization capabilities interrelate across the functionDescriptionThe Director, Medicaid Network Implementation is accountable for driving efficient management of network builds and implementations in new Medicaid markets. This position will translate network and provider strategies into tactical plans that can be executed on to ensure timely and successful new market launches. This position will lead a team of associates to direct the timelines, processes, provider data needs, and enterprise readiness to effectively implement network development strategies. Decisions are typically related supporting technical and operational procedures and processes, and implements strategic plans, drives goals and objectives, and improves processes and performance. The Director, Medicaid Network Implementation requires an in-depth understanding of how organization capabilities interrelate across the function or segment.ResponsibilitiesKey Responsibilities: Oversee market implementations to deliver adequate and accessible networks and positive provider experiences. Includes partnering with cross functional and matrixed teams to make key operational decisionsInform new market network development strategy and the creation of network development playbooks.Lead the network development through new market launch, including timelines, process maps, and process flow diagramsCreate the governance protocols to document and monitor processes, rules, requirements, metrics and performance, and standard operating procedures within division and among shared services partners where relevant.Oversee implementation of network and provider related contract requirements and RFP commitments to ensure they are on timePlan, organize, monitor, and oversee complex network implementations utilizing matrixed and cross functional teams to deliver defined requirements and meet company strategic objectivesDrive process improvements and operational gap closure to improve efficiencies of network builds and implementationsIdentify and solve problems that impact the management and direction of the business Build and maintain strong internal working relationships at all levels of the organization and across the Enterprise; leverage these relationships in helping to drive innovation and effective operations for Humana MedicaidEnsure high performance on team KPIs. Present regularly to senior leaders on progress and performanceEstablish and maintain standard operating procedures and policies to guide team workEffectively manage team of direct reports to execute on simultaneous priorities Required Qualifications Bachelor's Degree5+ years of progressive leadership experience7+ years of Medicaid managed care, network contracting, network operations, and/or provider relations experienceDemonstrated skills in developing and executing strategic playbooks or roadmaps in alignment with organizational goalsProven expertise in driving operational efficiencies and management of timelines and processes. Highly adept at managing processes from concept to completion ensuring on-time, on-budget, and on-target results.Passion for people development and demonstrated leadership successAbility to identify, structure and solve business problemsExcellent interpersonal, organizational, written, and oral communication and presentation skills with proven experience writing and delivering presentations to members of the management team and internal business partnersMust be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications Master's degreeSix Sigma certification