Director, Medicaid

Technical Summary:Reporting to the Senior Vice President of National Medicaid, the market Medicaid line of business leader is responsible for the overall performance of the NW markets Medicaid line of business programs, with a focus on financial performance and membership growth. Oversees all aspects of market Medicaid programs, state contracting arrangements, product development, compliance with State and Federal Policies and requirements. Strategically builds, manages and sustains external business relationships, particularly with state and local regulators. Accountable for product development, administrative processes, interdepartmental communication, and regulatory requirements. Develops an annual strategic plan and updates market and National Executive Sponsorship on strategic issues/development, business performance, and progress against objectives. Demonstrated passion and creativity in developing models of care serving low income vulnerable populations.Summary:This director level position is responsible for directing strategic, enterprise-wide, cross-regional, and/or multi-disciplinary programs to drive exceptional business value for KP; directing evolving strategic priorities and providing strategic planning within and across programs to drive and ensure alignment and performance across the organization. This includes ensuring the progress of initiatives are monitored across program(s) and proactively identifying risks and opportunities of strategic business value; addressing escalated issues to ensure effective resolution; and overseeing the identification, gathering and evaluation of data and key performance drivers to ensure strategy performance and address any gaps. This position is also responsible for directing the development of design plans and supporting the development and execution of change management strategies during key program or organizational changes and transitions; providing leadership in a variety of dynamic situations requiring exceptional consulting, internal influence, conflict management, and resource/team management; directing external research to identify and implement market leading practices; driving a 'can-do' strategic approach with sound business acumen; and advising and partnering with senior leaders while operating within a fast-paced environment.Core Responsibilities:Prepares individuals for growth opportunities and advancement; builds internal collaborative networks for self and others. Solicits and acts on performance feedback; drives collaboration to set goals and provide open feedback and coaching to foster performance improvement. Demonstrates continuous learning; oversees the recruitment, selection, and development of talent; ensures performance management guidelines and expectations to achieve business needs. Stays up to date with organizational best practices, processes, benchmarks, and industry trends; shares best practices within and across teams. Motivates and empowers teams; maintains a highly skilled and engaged workforce by aligning resource plans with business objectives. Provides guidance when difficult decisions need to be made; creates opportunities for expanded scope of decision making and impact.Oversees the operation of multiple units within a department by identifying member and operational needs; ensures the management of work assignment completion; translates business strategy into actionable business requirements; ensures products and/or services meet member requirements and expectations while aligning with organizational strategies. Gains cross-functional support for business plans and priorities; assumes responsibility for decision making; sets standards, measures progress, and fosters resolution of escalated issues. Communicates goals and objectives; analyzes resources, costs, and forecasts and incorporates them into business plans; prioritizes and distributes resources. Removes obstacles that impact performance; guides performance and develops contingency plans accordingly; ensures teams accomplish business objectives.Key Responsibilities:Directs the delivery of large-scale programs or components with multiple workstreams and strategic business goals across departments, functions, or regions with responsibility and accountability for achieving program outcomes from initiation to close-out in an extended or open ended time frame. Reviews program plans and determines program demands for the most complex program initiatives in order to identify and manage scope, and supply appropriate staffing to complete program plans within scope, budget and schedule. Oversees the program financials of large, high profile, dynamic program initiatives and ensures they are managed within budget allocations. Reviews performance across a portfolio of programs to ensure programs effectively deliver maximum long term value or benefit to the organization, and makes adjustments as needed in an uncertain environment where scope may be fluid. Develops and disseminates processes and procedures for the development and execution of organizational change management (e.g., user adoption, implementation, and training plans). Establishes and oversees proper program management practices in regard to allocation of resources, schedules and task assignments. This role may perform project management duties in addition to program management responsibilities.Directs programs team and holds team accountable for results. Oversees the decisions of others in reference to internal and/or external resource requests based on the alignment of team member skills and program demands. Leverages expertise to create a clear vision of overall program goals and objectives. Delivers performance feedback to team.Proactively monitors, identifies, and mitigates program risks, issues, and trigger events across multiple interdependent programs by leveraging expertise and recommending changes to program processes based on the analyses and identification of trigger events.Directs adherence of program activities to policies and procedures by ensuring program plans and team members follow KP, departmental, and/or business line policies and procedures.Directs the alignment, buy-in, engagement and support of diverse programs stakeholders to set long-term program goals by building and maintaining relationships as well as communicating appropriately with internal customers, third party vendors, executive management, and business leaders; and clarifying accountability and authority across stakeholders. Builds close relationships with key stakeholders across multiple functions based on their level of influence and decision making and guides teams in identifying the right stakeholders for their programs. Directs programs goals, influences the prioritization of deliverables, coordinates all business processes (e.g. project change management, communication) and facilitates decisions necessary for programs delivery by partnering with programs sponsors and/or review boards. Communicates tough issues to stakeholders while maintaining an independent opinion, providing recommendations, delivering formal presentations, and providing reports to executive audiences. Engages with senior and executive stakeholders to identify long term value to the organization and define success.Oversees vendor performance and provides direction for service improvements or revisions to strategy. Partners with Procurement and/or Legal to develop service level and/or scope of work agreements as appropriate. Directs partnerships and contract negotiations with vendors.Minimum Qualifications:Minimum five (5) years experience working with senior leadership to deliver cross-regional or multi-disciplinary strategic program management.Minimum four (4) years experience in a leadership role with direct reports.Minimum three (3) years experience managing operational or project budgets.Bachelor's degree from an accredited college or university and minimum twelve (12) years experience in project management or a directly related field, including minimum seven (7) years program management experience OR Minimum fifteen (15) years experience in project management or a directly related field including minimum seven (7) years program management experience.Additional Requirements:Knowledge, Skills, and Abilities (KSAs): Change Management; Negotiation; Applied Data Analysis; Financial Acumen; Business Relationship Management; Conflict Resolution; Managing Diverse Relationships; Project Management; Project Management Tools; Risk Assessment; Quality Assurance Process; Service Focus; Strategic Program Management.Preferred Qualifications:Five (5) years experience in strategic planning, consulting, and/or development, including helping define strategies and target business benefits or metrics.Master's Degree in Business Administration (MBA), Organizational Development (OD), or Project/Program Management.Four (4) years data analytics experience.Four (4) years healthcare experience.Four (4) years experience delivering presentations to executive management.Four (4) years experience working in a matrixed organization.Four (4) years experience working in a unionized environment.Four (4) years medical center operations project management experience.Four (4) years health plan administration experience.Four (4) years experience working for a Program Management Office (PMO).Four (4) years inter-regional project management experience.Four (4) years experience managing vendor contracts and relationships.Four (4) years experience developing and validating business cases, including identifying value of investment projects.Four (4) years experience delivering training programs.Master's degree from an accredited college or university.Project Management Professional (PMP) or equivalent project/program management certification.Completion of a project management educational training or certification program.Lean/Six Sigma certification.Other performance improvement certification (e.g., TQM, BPM, etc.).Four (4) years experience working with project management software.Four (4) years experience working with collaboration software (e.g., Sharepoint, MS Teams, etc.).

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