Director of Medicaid Services

This is a fully remote position, open to applicants in United States.

📋 Description

• Deliver strategic and operational leadership for a designated portfolio of Medicaid Services external quality review contracts, state customers, and programs.

• Ensure compliance with contract stipulations and relevant state and federal regulations.

• Act as the primary relationship leader for state Medicaid agencies, managed care organizations, subcontractors, and other stakeholders.

• Oversee project planning, execution, and performance assessment across scope, staffing, timelines, budgets, and deliverables.

• Lead and mentor project managers and team members; establish expectations, evaluate performance, facilitate development, and encourage accountability and collaboration.

• Manage the recruitment, selection, onboarding, training, evaluation, counseling, and corrective measures for assigned personnel.

• Ensure customer deliverables are precise, of high quality, internally reviewed and approved, and submitted punctually.

• Utilize SharePoint and Copilot to enhance workflows and optimize deliverable production.

• Monitor financial performance, staffing strategies, labor utilization, budgets, and forecasts.

• Identify and mitigate operational, contractual, staffing, and customer-related risks; escalate significant issues as necessary.

• Provide guidance to project leads on project design, data collection and abstraction, analysis, quality review, technical support, training, and report generation.

• Promote standardized, scalable processes along with continuous improvement, innovation, and knowledge sharing.

• Collaborate with HSAG departments and shared services to address cross-functional challenges and facilitate contract execution.

• Lead or assist with business development efforts, including proposals, presentations, scope creation, and pricing strategies.

• Support division planning, resource distribution, succession planning, performance tracking, and organizational priorities.

• Represent HSAG in customer meetings, presentations, conferences, and external events.

• Uphold confidentiality and adhere to company policies, contractual commitments, and regulatory standards.

⛳️ Requirements

• Master's degree in healthcare administration, public health, health services, business administration, or a related discipline, or an equivalent combination of education and relevant experience.

• At least eight years of progressively responsible experience in Medicaid, managed care, healthcare quality, external quality review, regulatory oversight, auditing, consulting, or a similar field.

• A minimum of five years in management or supervisory roles, including oversight of complex projects, customer relationships, budgets, and staff performance.

• Proven experience in leading multiple contracts or large, complex initiatives or projects and achieving results through other leaders and cross-functional teams.

• Experience with state Medicaid agencies, Medicaid managed care organizations, external quality review activities, or related state and federal healthcare programs is preferred.

• Background in supporting proposal development and business growth activities is preferred.

• Exceptional leadership, judgment, problem-solving, decision-making, and organizational abilities.

• Strong oral and written communication, presentation, facilitation, negotiation, and interpersonal skills.

• Capability to establish credibility and effective working relationships with customers, executive leaders, staff, subcontractors, and external stakeholders.

• Proficiency in analyzing complex operational, contractual, financial, and customer issues; developing practical solutions; and clearly communicating recommendations.

• Ability to manage competing priorities, multiple projects, and overlapping deadlines while maintaining a focus on detail and quality.

• Proficient in Microsoft Windows and Microsoft Office applications, including Microsoft Copilot, with the ability to learn and adapt to other business software.

• Commitment to maintaining confidentiality and consistently representing HSAG in a professional manner.

• Willingness to travel within the state and occasionally out of state as required.

🏝️ Benefits

• Salaried full-time exempt position.

• Flexible remote work arrangement.

• Reasonable accommodations available for individuals with disabilities.

• Limited travel, generally less than 5 percent.