Vice President, Medicaid Programs
Posted on: May 3, 2021
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PacificSource is an equal opportunity employer. All qualified
applicants will receive consideration for employment without regard
to status as a protected veteran or a qualified individual with a
disability, or other protected status, such as race, religion,
color, national origin, sex, sexual orientation, gender identity or
Diversity and Inclusion: PacificSource values the diversity of
the people we hire and serve. We are committed to creating a
diverse environment and fostering a workplace in which individual
differences are appreciated, respected and responded to in ways
that fully develop and utilize each person's talents and
Position Overview: This position is a member of the
PacificSource leadership team and, together with the EVP-Lines of
Business, is responsible for driving success in the company's
Medicaid line of business. This includes ensuring the organization
accomplishes its goals around quality, cost, and health improvement
on behalf of its Medicaid members. The position leads both internal
teams (both direct and dotted-line reporting) and external partners
in aligning strategic planning efforts, resource allocation, and
management objectives to enhance PacificSource's Medicaid line of
business. The VP of Medicaid Programs helps PacificSource emerge as
a nationally recognized leader in a rapidly changing health reform
environment by informing state-level policy making, participating
in community and consumer driven governance models, leading
multi-stakeholder strategic planning efforts, and effectuating
internal work plans. The VP is considered the line of business
leader with responsibility for PacificSource's Coordinated Care
Organizations (CCOs), the Integrated Delivery System within Health
Share of Oregon, and other Medicaid activities in the broader
PacificSource service area.
Business and Operating Objectives
- Develop strategic business partnerships with state and local
government, providers, agencies, and internal PacificSource leaders
to ensure priority Medicaid objectives are consistently
- Lead internal Steering Committees and work groups tasked with
monitoring end-to-end performance of PacificSource Medicaid line of
business, and developing action plans for underperforming areas.
These include financial and operating performance, quality of care,
member engagement and satisfaction, provider access and engagement,
health care transformation efforts, contractual deliverables, and
- Build/maintain relationships with PacificSource's Medicaid
community governance partners, providers, community leaders, and
other external stakeholders. Align PacificSource and community
partner interests toward the accomplishment of common, community
level health outcomes.
- Build and maintain relationships with key departments and
personnel within regulatory agencies, including state Medicaid
agencies, governors' offices, and other entities with oversight or
influence on state Medicaid programs.
- Inform and guide state Medicaid policy development by ensuring
adequate company participation in committees and workgroups.
- Assume a central role in working with providers, county health
departments, regulatory agencies, and other partners to orchestrate
care model improvements for individuals enrolled in Medicaid
delivered by PacificSource.
Development and growth opportunities
- Monitor and participate in managed Medicaid development and
growth opportunities, including in PacificSource markets outside
- Strategize growth and business development opportunities for
the Medicaid line of business and lead implementation of any
resulting product, benefit, operating, and provider network
- Closely monitor healthcare policy and legislative developments,
as well as decisions within the key agencies that impact the
Medicaid line of business. Translate the impact of policy decisions
to the organization; lead communication, planning, and
implementation efforts required for the organization to respond to
policy changes in a timely manner.
- Ensure internal PacificSource operations synergize with the
core competencies of external community partners. Improve Medicaid
member experience and quality of care by effectively leveraging
both PacificSource's core competencies and those of its
- Lead all PacificSource efforts associated with Medicaid
procurement. Partner with other executives and subject matter
experts to craft procurement strategies and value propositions.
Execute on procurement requirements and oversee corresponding
implementation of new contracts.
- In partnership with regional Vice Presidents and other
executive leadership, design and implement new or improved
community governance models to meet PacificSource and community
Internal and External Collaboration
- Engage in PacificSource's community governance model by
participating on local Health Council Boards, standing committees,
and ad hoc committees.
- Collaborate closely with the VP of Government Relations and
other subject matter experts regarding legislative initiatives and
communication with state representatives.
- Work closely with the Chief Compliance Officer to ensure
internal performance and policies and procedures are in alignment
with state and federal legislation.
Internal Alignment and Leadership Engagement
- Align company level and functional/departmental priorities with
Medicaid line of business priorities to enhance Medicaid
performance and accountability. Work directly with department
leaders to ensure knowledge, priorities, and actions ultimately
accomplish line of business aims on behalf of PacificSource members
and community partners. Maintain collaborative partnerships with
key departments and leaders.
- Actively engage and inform the Executive Management Group on
Medicaid performance, developments, and growth opportunities
- Actively participate as a key team member in company leadership
- Actively participate in various strategic and internal
committees in order to disseminate information within the
organization, represent company philosophy, and preserve visibility
within the community.
- Responsible for hiring, staff development, coaching,
performance reviews, corrective actions, and termination of
employees. Provide feedback, including regular one-on-ones and
performance evaluations, for direct reports.
- Responsible for process improvement and working with other
departments to improve interdepartmental processes. Utilize
methodologies that promote continuous improvement. Utilize
appropriate tools and strategies to monitor key performance
indicators and identify improvement opportunities.
- Actively participate as a key team member in manager
Meet department and company performance and attendance
laws and regulations concerning confidentiality and security of
protected health information. Perform other duties as assigned.
Work Experience: Minimum of ten years' experience in the health
insurance industry, specifically health policy and line of business
leadership. Managed Medicaid experience required. Five years in a
significant leadership role is required. Experience building and
implementing Medicaid business development strategies is required.
Experience leading Medicaid performance for plans across multiple
markets and interacting with diverse Medicaid programs is strongly
Education, Certificates, Licenses: Bachelor's degree required
with preferred focus in business, health care administration,
public health, or clinical; Masters preferred
Knowledge: Effectively present information to and respond to
questions from a variety of groups, including staff, management,
boards of directors, employees and community stakeholders.
Knowledge of strong consensus building and inclusive/non-consensus
solution building. Ability to create synergy by facilitation
collaboration among independent entities. Comprehensive knowledge
of business principles and techniques of administration,
organization and management. Health care leadership, planning and
development experience with in-depth understanding of health care
issues and trends. Comprehensive understanding of key issues
existing in the health care industry. These include but are not
limited to: federal, state, and local policies and trends in the
- Building Organizational Talent
- Coaching and Developing Others
- Cultivating Networks
- Customer Focus
- Emotional Intelligence
- Establishing Strategic Direction
- Leading Change
- Optimizing Diversity
- Passion for Results
Environment: Work inside in a general office setting with
ergonomically configured equipment. Travel is required between
various offices and locations primarily in Oregon, Idaho,
Washington, and Montana approximately 40% of the time.
- We are committed to doing the right thing.
- We are one team working toward a common goal.
- We are each responsible for customer service.
- We practice open communication at all levels of the company to
foster individual, team and company growth.
- We actively participate in efforts to improve our many
communities-internally and externally.
- We actively work to advance social justice, equity, diversity
and inclusion in our workplace, the healthcare system and
- We encourage creativity, innovation, and the pursuit of
Physical Requirements: Stoop and bend. Sit and/or stand for
extended periods of time while performing core job functions.
Repetitive motions to include typing, sorting and filing. Light
lifting and carrying of files and business materials. Ability to
read and comprehend both written and spoken English. Communicate
clearly and effectively.
Disclaimer: This job description indicates the general nature
and level of work performed by employees within this position and
is subject to change. It is not designed to contain or be
interpreted as a comprehensive list of all duties,
responsibilities, and qualifications required of employees assigned
to this position. Employment remains AT-WILL at all times.
Keywords: PacificSource, Salem , Vice President, Medicaid Programs, Other , Salem, Oregon
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