Manager, Medicaid Programs

Overview

Are you a community health leader who is looking to use your expertise to improve the health and well-being of people on a larger, programmatic scale? Do you have experience collaborating across healthcare systems, networks, and payers to effectively manage population health initiatives and Medicaid programs? Are you known as an advocate for all, who is committed to delivering high-quality healthcare products and programs, as measured by positive outcomes and impacts?

If you answered “yes” to the above, please consider joining leadership team as a Manager, Medicaid Program. This role will oversee people, processes, programs, and products responsible for fulfilling community health needs, including assessing and addressing social determinants of health, patient activation & education, and building trust between communities and healthcare providers.

Benefits:

• Full-time virtual, telecommuting, work from home environment available
• Apply expertise, advise leadership and stakeholders across the organization and provider network to fulfill the organization’s strategic objectives and community health needs
• Develop programs that deliver widespread, positive impacts on the lives of members and patients
• Ideal starting base compensation range of $85,000 - $100,000 robust total rewards package

Responsibilities

• Lead and manage Quartz Medicaid programs - leading project plans to enhance the Medicaid operational infrastructure, ensuring adequate resources and services across the organization and affiliates, and making personnel decisions accordingly
• Stay up to date on CMS and State regulations, guidance, and system changes; disseminate information across the organization and assist with necessary audits to ensure compliance
  • Oversee and support the development and maintenance of product documentation, including Medicaid training materials, policies, & procedures
• Develop partnerships to work collaboratively with internal stakeholders and external community organizations to leverage existing assets to address the unique risks, needs and opportunities of the local market
  • Gather key information on market and regulatory landscape in prospective new markets to inform local market strategy help develop population health and clinical delivery models to exceed regulatory requirements and successfully position Quartz in the marketplace
  • Coordinate with staff to provide technical expertise to external stakeholders, cultivating a self-sustaining mind-set, engaging leaders in the various capacity-building programs offered, and identifying and creating additional opportunities to diversify local economies that create long-term viability.
  • Identify areas for self, staff, and organizational development and actively seek opportunities and resources to meet developmental objectives
  • Serve as a loyal, informed representative and advocate of Quartz and the communities it serves
• Advise leadership on advancing the organization’s social investment strategy - ensuring accountability with organizational recipients and providing technical guidance to potential applicants on project design, sustainability effectiveness, and achievement of outcomes - ensuring community impacts are considered in various operational activities and initiatives
  • Create and deliver presentations, reports and profiles to share successes, opportunities and stories to communicate the importance and relevance of Social Determinants of Health and community development to the organization
  • Participate and/or conduct focus group sessions in support of growth and social investment strategy
  • Participate in financial forecasting and planning, managing fiscal targets and making program recommendations as needed

Qualifications

• Bachelor’s Degree in health education, nursing, or related health field required; Master’s Degree preferred
• 5 years of experience working in healthcare or business administration, with expert knowledge of Medicaid administration
• 2 years of leadership experience
• Deep subject matter expertise in CMS and State Medicaid requirements, including provider materials, formulary/PDL, coverage determinations, grievances and appeals, customer care, third party liability, and reporting
• Demonstrated experience analyzing and presenting data to drive outcomes
• Leadership experience - ability to train, supervise, and inspire others to execute upon the vision and drive positive program outcomes
• Experience communicating and working effectively with healthcare providers
• Ability to manage and prioritize tasks to meet deadlines
• Valid driver’s license and access to personal transportation or other reliable means for regional travel on a regular basis

This full-time position can work remotely, with regular travel throughout the service area and to the Madison, WI office expected. Hardware and equipment will be provided by the company, but candidates must have access to high-speed, non-satellite Internet to successfully work from home.

Quartz offers an excellent benefit and compensation package, opportunity for career advancement and a professional culture built upon the foundations of Respect, Responsibility & Relationships. Quartz is a federal contractor and supports a safe, drug-free workplace. All employment offers are contingent upon successful completion of a pre-employment criminal background check and drug screening.

Quartz values and embraces diversity and is proud to be an Equal Employment Opportunity, Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, gender identity or expression, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.