Manager, Medicaid/Charitable Operations & Contract Administration Job in Portland, Oregon US
Manager, Medicaid/Charitable Operations Contract Administration
At Kaiser Permanente Northwest, the work you do every day supports the health of our members. That's because each of us-from our business professionals and IT team members to our RNs and physicians on the front line of care-shares a commitment to providing the best possible care experience. Widely regarded as a mecca for outdoor enthusiasts, the Pacific Northwest blends urban bustle with open space in a way that is sure to enhance your own state of well-being. Looking to build a rewarding career in an environment that supports your success? Join us and put your beliefs into practice. Accountable for building and strengthening the internal operational infrastructure for Medicaid programs while ensuring 100% compliance with state/federal/payer expectations. This leadership position within KPNW is accountable for implementing the organization's commitment to and adequate participation in Medicaid and Charitable Programs. Strives to achieve the goal of KPNW serving as a leading provider of health care to low income individuals and families. Essential Functions: - Facilitate strong operational processes within operational departments to ensure Medicaid contractual and financial considerations are efficient, cost effective and compliant - Requires oversight of all operational, administrative and reporting issues related to the Medicaid and Charitable Programs - Establish business metrics and ongoing reporting against the metrics; the development of Medicaid, finance and compliance infrastructure to support the Medicaid/Special Populations business lines - Negotiate, implement and oversight all Medicaid and Charitable Program contracts/MOU's for KPNW ensuring compliance with all provisions contained within each agreement - Requires developing and maintaining relationships with leaders in each State Department and those in Community Benefit-sponsored organizations. Proactively anticipate and respond to state and federal initiatives which impact Medicaid, Community Benefit and KPNW - With KP Finance and Actuarial, build and maintain a strong forecasting and costing system with strong metrics to guide decision-making - Working with the Director, Medicaid Charitable Programs, manage costs savings initiatives, reporting regularly based on agreed upon metrics Secondary Functions: - Participate in the development of a rolling multi-year strategy and business plan for Medicaid/Special Populations offerings that achieve overall strategic direction while using and investing resources appropriately - Work includes working closely with Senior Leadership across Operations, HPA and Medical delivery to ensure alignment with organizational strategy and goals - Directly supervise Medicaid Charitable Product Administrator and Product Administrator, ensuring compliance with contract requirements, review and submission deadlines and required reporting Requirements