Job Highlights:
- Location: Phoenix, AZ (Hybrid - 2 days in office)
- Compensation: Competitive Salary & Benefits
- Company: Workwarp (Partnering with Aetna Behavioral Health)
- Start Date: Immediate
A dynamic and strategic leader is needed to oversee all critical operational functions for our comprehensive Medicaid business. Reporting to the Program Manager, the Director of Operations will be instrumental in the successful development and execution of the Medicaid program, including financial management and collaboration with internal and external stakeholders. This role is a key leadership position, requiring a dedicated and results-oriented individual passionate about employee growth and driving continuous improvement for the organization and its members.
Key Responsibilities:
- Provide leadership and management to a service organization aligned with the company's mission and core values.
- Ensure employee compliance with business principles, including operational management and process improvements.
- Develop and present timely, accurate, and comprehensive reports on program performance.
- Develop and implement strategies for assigned areas, and evaluate new and changed programs as appropriate.
- Partner with the Program Manager on development, communication, and implementation of successful program methodologies and processes.
- Lead the implementation of new programs, services, and grant proposals.
- Collaborate with the Program Leadership team to develop and execute action plans for operational systems, processes, and staff to achieve organizational goals.
- Assist in defining marketing and public relations strategies within state guidelines.
- Participate in the development and execution of marketing plans for the Medicaid program, ensuring alignment with program regulations.
- Assist with budget planning and variance reporting for assigned areas.
- Work collaboratively with the Organizational Development team to enhance the provider network.
- Serve as a key point of contact with regulatory and other state agencies, conveying information to leadership and reporting back to the Program team.
- Ensure compliance with all applicable laws, regulations, company policies, and procedures for assigned areas.
Qualifications:
- Must reside in Arizona or be willing to relocate. Relocation assistance will be provided to qualified candidates.
- Ability to work a hybrid model (2 days in office).
- Proven experience in taxpayer-supported initiatives such as Medicaid, Medicare, or Dual Eligible, with a strong foundation in compliance.
- Deep understanding of claims systems and processes, value-based arrangements, TP/COB, pharmacy claims, network contracting, call center management, and provider data.
- Strong understanding of how quality and compliance programs (NQA and HEDIS) impact the program.
- Proficiency in credentialing, provider relations, and network development to ensure sufficiency and reimbursement.
- Strong understanding of Medicaid marketing, member and provider communications, community program engagement, and SDOH (housing, employment, CHWs, peer support, and nutrition).
- Working knowledge of the relationship between physical and social well-being, and the unique aspects of behavioral health in serving the Medicaid population.
- Ability to collaborate effectively across multiple teams, prioritize requests, integrate information, and draw meaningful conclusions.
- Demonstrated leadership in initiatives such as business process improvement, project management, financial planning and analysis, and risk management.
- Commitment to diversity, equity, and inclusion through ongoing development, inclusive behaviors, and proactive bias management.
Are You the One We're Looking For?
If you are a passionate and results-oriented leader with a proven track record in Medicaid operations, we encourage you to apply. Submit your application today! We are eager to hear from talented candidates like you.
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