Humana Medicaid State Implementation Lead - WAH in Springfield, Missouri
The Medicaid State Implementation Lead provides support to existing and new Medicaid implementations.
The Medicaid State Implementation Lead works on projects of diverse scope and complexity with potential revenue projections over a Billion dollars. Critical thinking is required and this position is responsible for being a thought leader able to influence change and implement large-scale programs.
Develop internal and external partnerships and related strategies to meet requirements of varying dual eligible and Medicaid models.
Work collaboratively with a variety of cross-functional teams and thought leaders to deliver committed program capability.
New Business Development - primary responsibilities include:
As a representative of the Medicaid Implementation team, provide strategic leadership as we evaluate market entry strategies in pipeline markets and respond to Requests for Proposals for new lines of business.
Participate in the RFP Response process along with the Business Development team working closely with cross-functional Medicaid leaders to shape the Strategy and commitments.
Identify new and innovative opportunities and programs and work across the Medicaid leadership team to develop a plan to implement them.
New State and/or contract re-procurements - primary responsibilities include:
Developing and executing on the end-to-end business implementation model
State relationship management throughout the implementation process
Support new Market resources upon onboarding
Participate in business requirements sessions ensure all requirements are accounted for including maintenance and requirements tractability. .
Implementation Schedule creation and maintenance
Executive summary status reporting and issue/risk escalation
Owns key Project Meetings with Stakeholders and Leadership.
Actively participate in Business Readiness Validation and State Readiness Review.
Ensure compliance with coordinating CMS and State Medicaid regulations.
Bachelor's degree or equivalent experience.
3 - 5 years' experience with Medicaid/Medicare operations/healthcare experience.
5 - 7 years managing large scale projects and cross functional teams.
Success in developing working relationships within a highly matrixed business environment.
Ability to analyze data and make informed recommendations.
Experience managing and facilitating with the ability to influence without having authority.
Act as a thought leader with strong verbal and written communication skills (ability to interact effectively with people at all levels within a team or internal division).
Strong critical thinking, problem solving skills; detailed and well organized.
Demonstrates accuracy and thoroughness, identifies process improvements, fosters quality in others.
Accepts responsibility, is self-motivated and accountable for achieving implementation and market satisfaction goals.
Works within deadlines, demonstrates independence, resourcefulness and self-management skills.
Works well within an ambiguous environment where direction is always subject change.
Ability to flow to the work as capacity demands change.
Experience responding to state and/or federal government solicitations.
Knowledge of Humana's internal policies, procedures and systems.
Scheduled Weekly Hours