Director of Medicaid Enterprise Development

OVERVIEW

The Division of Medicaid Services (DMS) is directly responsible for the management of Medicaid services under state plan including the Medicaid Care Management Program (MCM) and Medicaid financing and integration for all Medicaid services with the Center for Medicare and Medicaid Services (CMS). NH Medicaid currently covers around 165,000 beneficiaries of which a significant portion are children. Other covered populations include pregnant women, low-income adults, elderly and disabled children and adults. DMS directly manages a $1.8 billion budget.

SUMMARY

Performs highly advanced (senior-level) policy administration, analytical and managerial work. Work involves specialized knowledge of state government, strategic planning and agency administration. Works closely with the Medicaid Director and Deputy Director on the day-to-day operations of DMS and DMS' integration and coordination of Medicaid across the DHHS, and other state and federal agencies as well as external organizations. In addition serves as lead in collaboration with the Director of Information Services, the Department of Information Technology, and the MMIS Director in the planning and operation of the Medicaid Management Information System (MMIS), a claims processing and information retrieval system, and other Medicaid enterprise systems. Manages DMS program operation teams. Works under minimal supervision with extensive latitude for the use of initiative and independent judgment.

RESPONSIBILITIES

• Assists Medicaid Director to ensure that the agency adheres to goals and objectives.
• Provides advice to the Medicaid Director regarding agency operations.
• Manages assigned day-to-day operations of DMS and its integration with DHHS and external partners.
• Analyzes assigned program objectives and directs staff activities to accomplish desired results; meets with government officials, medical professionals, and others to explain the agency’s position.
• Collaborates with General Counsel for DMS and the Medicaid Director on legislative activities; presents testimony at hearings and drafts legislation.
• Represents DHHS at legislative and regulatory hearings.
• Coordinates and oversees multidisciplinary initiatives and projects.
• Provides information and advice to state agencies, the legislature, Governor’s Office and the general public regarding agency activities and responsibilities.
• Requires frequent interface with outside agencies, primarily but not only, the Centers for Medicare and Medicaid Services (CMS).
• Coordinates program efforts with other agency sections/units to assure agency compliance with federal and state regulations by ensuring coordination and maintenance of NH administrative rules and State Plan Amendments.
• Undertakes leadership responsibility for special projects operation and compliance as assigned;
• May act as Medicaid Director in the absence of the Director or Deputy Director.

  MINIMUM QUALIFICATIONS

  • A Master’s or Graduate level equivalent Degree from an accredited college or university with major course work in public administration, public health, public policy, health care policy and management, or law.
  • Eight years’ experience in public policy administration and/or management work or significant operational responsibility in a health care institution or health insurer.
  • Preference will be given to candidates with public administration, public health, law or a health care policy and management background who have worked within a state and/or federal medical assistance program, or have significant operational responsibility in a health care institution or health insurer.

  PREFERRED QUALIFICATIONS

  • Knowledge of local, state, and federal laws and regulations; specifically knowledge of CMS regulations and processes for state plan, institutional and waiver programs.
  • Knowledge of the principles and practices of public administration and management, or institutional health care services.
  • Demonstrated ability to direct and organize program activities; to establish program goals and objectives that support the strategic plan; to identify problems, evaluate alternatives and implement effective solutions; to develop and evaluate policies and procedures; to direct the development of agency policies and procedures; to prepare concise reports; to make presentations and testify at hearings; and to plan, assign, and/or supervise the work of others.