Medicaid Provider Solutions Senior Manager, Consulting - Medicaid Care Delivery and Operations
Posted 2025-08-15
Remote, USA
Full Time
Immediate Start
About the position
As of January 1, 2024, Kaiser Foundation Health Plan, Inc. has entered into a direct contract with the Department of Health Care Services (DHCS) to provide Medi-Cal services to enrollees across 32 counties in California. The Senior Manager on the Medi-Cal Provider Solutions team will play a pivotal role in leading and overseeing the development, implementation, and management of a comprehensive provider network strategy. This position is crucial for building and maintaining strong relationships with healthcare providers and associations, ensuring compliance with regulations, and optimizing network performance to enhance access to quality care for Medi-Cal beneficiaries. The Senior Manager will collaborate with cross-functional teams to drive initiatives aimed at improving provider satisfaction, streamlining operations, and supporting the overall organizational goals. In this role, the Senior Manager will manage a team of consultants, ensuring alignment, buy-in, and coordination among diverse stakeholders to successfully implement business initiatives and projects. The position requires empowering the development and implementation of business initiatives, systems, and processes to achieve a desired future state. The Senior Manager will oversee the development of multiple business strategies, ensuring alignment and prioritization of organizational objectives and business initiatives. Additionally, the role involves managing complex projects or project components, overseeing change management plans, and guiding team members in performing complex data analyses to drive business initiatives. The Senior Manager will also direct vendor management as required and monitor compliance with relevant policies and procedures. The Senior Manager will create and advocate for developmental opportunities for team members, build collaborative relationships, and foster open dialogue among team members. This includes soliciting and acting on performance feedback, setting goals, and providing coaching to drive performance improvement. The role also involves overseeing the implementation of best practices, adapting to organizational changes, and sharing insights across teams. The Senior Manager will be responsible for translating business plans into tactical action items, ensuring that all policies and procedures are followed, and partnering with key stakeholders to meet product and service requirements. Furthermore, the position requires managing the development of requirements for complex business solutions, empowering team members to utilize appropriate data analysis methods, and ensuring the delivery of measurable results aligned with strategic objectives.
Responsibilities
• Lead and oversee the development, implementation, and management of a comprehensive provider network strategy.
,
• Build and maintain strong relationships with healthcare providers and associations.
,
• Ensure compliance with regulations and optimize network performance to enhance access to quality care for Medi-Cal beneficiaries.
,
• Collaborate with cross-functional teams to drive initiatives that improve provider satisfaction and streamline operations.
,
• Manage a team of consultants to ensure alignment and coordination of diverse stakeholders for successful business initiatives.
,
• Empower the development and implementation of business initiatives, systems, and processes to a desired future state.
,
• Oversee the development of multiple business strategies and ensure alignment with organizational objectives.
,
• Manage complex projects or project components and change management plans.
,
• Guide team members in performing complex data analyses to drive business initiatives.
,
• Direct vendor management as required and monitor compliance with relevant policies and procedures.
Requirements
• Minimum five (5) years experience in a leadership role with or without direct reports.
,
• Bachelor's degree from an accredited college or university and minimum eight (8) years experience in consulting, project management, data analytics, operations or a directly related field OR Master's degree in Business, Public Health, or a directly related field and minimum six (6) years experience in consulting, project management, data analytics, operations or a directly related field OR minimum eleven (11) years experience in consulting, project management, data analytics, operations or a directly related field.
,
• Knowledge of business acumen, change management, negotiation, creativity, applied data analysis, financial acumen, conflict resolution, managing diverse relationships, process validation, project management, risk assessment, service focus, requirements elicitation & analysis.
Nice-to-haves
• Two (2) years supervisory experience.
,
• Four (4) years data analytics experience.
Benefits
• Health insurance coverage
,
• Dental insurance coverage
,
• Vision insurance coverage
,
• 401k benefit for retirement savings plan
,
• 401(k) matching benefit
,
• Paid holidays
,
• Flexible scheduling options
,
• Professional development opportunities
,
• Employee discount programs
,
• Wellness programs Apply tot his job
As of January 1, 2024, Kaiser Foundation Health Plan, Inc. has entered into a direct contract with the Department of Health Care Services (DHCS) to provide Medi-Cal services to enrollees across 32 counties in California. The Senior Manager on the Medi-Cal Provider Solutions team will play a pivotal role in leading and overseeing the development, implementation, and management of a comprehensive provider network strategy. This position is crucial for building and maintaining strong relationships with healthcare providers and associations, ensuring compliance with regulations, and optimizing network performance to enhance access to quality care for Medi-Cal beneficiaries. The Senior Manager will collaborate with cross-functional teams to drive initiatives aimed at improving provider satisfaction, streamlining operations, and supporting the overall organizational goals. In this role, the Senior Manager will manage a team of consultants, ensuring alignment, buy-in, and coordination among diverse stakeholders to successfully implement business initiatives and projects. The position requires empowering the development and implementation of business initiatives, systems, and processes to achieve a desired future state. The Senior Manager will oversee the development of multiple business strategies, ensuring alignment and prioritization of organizational objectives and business initiatives. Additionally, the role involves managing complex projects or project components, overseeing change management plans, and guiding team members in performing complex data analyses to drive business initiatives. The Senior Manager will also direct vendor management as required and monitor compliance with relevant policies and procedures. The Senior Manager will create and advocate for developmental opportunities for team members, build collaborative relationships, and foster open dialogue among team members. This includes soliciting and acting on performance feedback, setting goals, and providing coaching to drive performance improvement. The role also involves overseeing the implementation of best practices, adapting to organizational changes, and sharing insights across teams. The Senior Manager will be responsible for translating business plans into tactical action items, ensuring that all policies and procedures are followed, and partnering with key stakeholders to meet product and service requirements. Furthermore, the position requires managing the development of requirements for complex business solutions, empowering team members to utilize appropriate data analysis methods, and ensuring the delivery of measurable results aligned with strategic objectives.
Responsibilities
• Lead and oversee the development, implementation, and management of a comprehensive provider network strategy.
,
• Build and maintain strong relationships with healthcare providers and associations.
,
• Ensure compliance with regulations and optimize network performance to enhance access to quality care for Medi-Cal beneficiaries.
,
• Collaborate with cross-functional teams to drive initiatives that improve provider satisfaction and streamline operations.
,
• Manage a team of consultants to ensure alignment and coordination of diverse stakeholders for successful business initiatives.
,
• Empower the development and implementation of business initiatives, systems, and processes to a desired future state.
,
• Oversee the development of multiple business strategies and ensure alignment with organizational objectives.
,
• Manage complex projects or project components and change management plans.
,
• Guide team members in performing complex data analyses to drive business initiatives.
,
• Direct vendor management as required and monitor compliance with relevant policies and procedures.
Requirements
• Minimum five (5) years experience in a leadership role with or without direct reports.
,
• Bachelor's degree from an accredited college or university and minimum eight (8) years experience in consulting, project management, data analytics, operations or a directly related field OR Master's degree in Business, Public Health, or a directly related field and minimum six (6) years experience in consulting, project management, data analytics, operations or a directly related field OR minimum eleven (11) years experience in consulting, project management, data analytics, operations or a directly related field.
,
• Knowledge of business acumen, change management, negotiation, creativity, applied data analysis, financial acumen, conflict resolution, managing diverse relationships, process validation, project management, risk assessment, service focus, requirements elicitation & analysis.
Nice-to-haves
• Two (2) years supervisory experience.
,
• Four (4) years data analytics experience.
Benefits
• Health insurance coverage
,
• Dental insurance coverage
,
• Vision insurance coverage
,
• 401k benefit for retirement savings plan
,
• 401(k) matching benefit
,
• Paid holidays
,
• Flexible scheduling options
,
• Professional development opportunities
,
• Employee discount programs
,
• Wellness programs Apply tot his job