Senior Manager, Regulatory Oversight & Improvement
Medica's Senior Manager, Regulatory Oversight & Improvement is responsible for managing provision of mandated CMS/DHS regulatory reporting for Medicaid & Special Needs Plans (SNP), delegated care coordination services, regulatory required improvement projects, as well as delegate and internal clinical training.
* Designing, developing, and implementing improvement initiatives for Medicare Advantage, PMAP, MNCare, MSHO, MSC+, SNBC and all SNP's
* Developing and maintaining relationships with resources internally as well as externally with regulators such as CMS and DHS.
* Representing Medica at multiple external stakeholder meetings, regulator led workgroups, and acting as an industry SME for local and national organizations such as SNP Alliance
* Managing Medica's delegation review and oversight of all care coordination entities providing care coordination services to Medica members
Our Manager works directly with managers and directors from Government Programs, Legal, Compliance, Marketing Communications, Sales, Health Care Economics and Health Services divisions at Medica.
* Bachelor's degree or equivalent combination of education and experience; Master's degree preferred
* 10+ years related experience in a MN government programs and/or regulatory environment
* Experience leading teams, including managing direct reports
* Experience working with state and federal contracts within Medicare and/or Medicaid required
* Understanding of care coordination services and/or products required
* Compliance, regulatory oversight, or healthcare auditing and improvement experience preferred
Skills and Abilities:
* Ability to see the bigger picture while maintaining a strong attention to detail
* Ability to strategize and solve problems while working with ambiguity
* Strong communication skills with the ability to intera
$96k-157k yearly est.