Director of Medicaid Services - REMOTE

Summary

Under general direction of the Executive Director or Vice President, Medicaid Services, this position provides strategic and operational leadership for an assigned portfolio of Medicaid Services external quality review (EQR) contracts, state customers, and programs. The Director is accountable for contract performance, customer satisfaction, budget management, quality and timeliness of deliverables, workforce planning, and staff development. The position serves as a liaison between a state and project that leads to support cross-functional initiatives and EQR tasks; supports business development and proposal activities; and translates EQR strategy into effective deliverables. The Director provides leadership and guidance to project managers, and other assigned staff and serves as a senior point of contact for state customers and internal partners.

Essential Competencies, Duties and Responsibilities

• Provide strategic oversight for an assigned portfolio of Medicaid Services EQR contracts, ensuring alignment with contract requirements and applicable state and federal requirements.
• Serve as the senior relationship leader for state Medicaid agencies, managed care entities, subcontractors, and other stakeholders; proactively resolve concerns affecting customer satisfaction.
• Direct project planning, implementation, and performance monitoring across scope, staffing, schedules, budgets, and deliverables.
• Lead and coach project managers and other assigned staff by setting expectations, monitoring performance, supporting development, and fostering accountability and collaboration.
• Manage recruitment, selection, onboarding, training, evaluation, counseling, and corrective action for assigned staff in coordination with Human Resources and executive leadership.
• Ensure customer deliverables are accurate, high quality, internally reviewed and approved, and submitted on time.
• Leverage tools such as SharePoint and Copilot to streamline workflows and improve deliverable production.
• Monitor financial performance, including staffing plans, labor utilization, budgets, and forecasts, in coordination with Finance and executive leadership.
• Identify and mitigate operational, contractual, staffing, and customer risks; escalate significant concerns to the Executive Director or Vice President.
• Advise project leads on project design, data collection and abstraction, analysis, quality review, technical assistance, training, and report development, as applicable.
• Advance standardized, scalable processes and promote continuous improvement, innovation, and knowledge sharing across projects.
• Coordinate with HSAG departments and shared services to resolve cross-functional issues and support high-quality contract execution.
• Lead or support business development activities, including proposals, presentations, scope of development, and pricing assumptions.
• Support division planning, resource allocation, succession planning, performance reporting, and organizational priorities under the direction of the Executive Director or Vice President.
• Represent HSAG professionally in customer meetings, presentations, conferences, and other external forums.
• Maintain confidentiality and comply with company policies, contractual obligations, and regulatory requirements.
• Work with the Executive Director or Vice President to minimize extended work hours, which may occasionally be required to meet project deadlines.
• Perform other duties as assigned.

Education and/or Experience

• Master's degree in healthcare administration, public health, health services, business administration, or a related field, or an equivalent combination of education and relevant experience.
• Minimum of eight years of progressively responsible experience in Medicaid, managed care, healthcare quality, external quality review, regulatory oversight, auditing, consulting, or related field.
• Minimum of five years of management or supervisory experience, including responsibility for complex projects, customer relationships, budgets, and staff performance.
• Demonstrated experience leading multiple contracts or large, complex initiatives or projects and delivering 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 preferred.
• Experience supporting proposal development and business growth activities preferred.

Other Qualifications

• Excellent leadership, judgment, problem-solving, decision-making, and organizational skills.
• Excellent oral and written communication, presentation, facilitation, negotiation, and interpersonal skills.
• Ability to establish credibility and effective working relationships with customers, executive leaders, staff, subcontractors, and external stakeholders.
• Ability to analyze complex operational, contractual, financial, and customer issues; develop practical solutions; and communicate recommendations clearly.
• Ability to manage competing priorities, multiple projects, and overlapping deadlines while maintaining attention to detail and quality.
• Proficiency with Microsoft Windows and Microsoft Office applications, including Microsoft Copilot, and the ability to learn and use other business software.
• Ability to maintain confidentiality and consistently represent HSAG in a professional manner.
• Ability to travel statewide and out of state as needed. Travel is expected to be limited and generally less than 5 percent.