Director, Medicaid & Managed Care Strategy

Doc PersonalBeratung GmbH; Cayce (SC); On-site; USD 120,000 - 180,000; Full time

Benefits offered by this job

Health insurance

Retirement plan

Paid time off

Job summary

SC Department of Behavioral Health and Developmental Disabilities (BHDD) seeks a Director of Managed Care to lead Medicaid and managed care activities. You will serve as Finance’s principal expert and liaison with SCDHHS, oversee enrollment, reimbursement, and revenue cycle operations, and coordinate cross-functional responses to payer issues.

The role requires a Master’s degree and substantial Medicaid experience, with leadership responsibilities and experience in behavioral health or large

Qualifications

• Master’s degree in business, healthcare administration, public administration, finance, or related field.
• Significant experience with Medicaid, preferably South Carolina Medicaid.
• Experience with Medicaid reimbursement methodologies, payer contracting, provider enrollment, and revenue cycle operations.
• Experience working with a state Medicaid agency or Medicaid managed care organizations.
• Experience within behavioral health or large healthcare delivery systems.
• Prior supervisory or leadership experience.

Responsibilities

• Develop and maintain subject matter expertise on SC Medicaid programs for BHDD.
• Liaise with SCDHHS, MCOs, and stakeholders on Medicaid policy and reimbursement.
• Coordinate managed care contracting and enrollment requirements with Legal and leadership.
• Evaluate reimbursement methodologies and identify revenue-improvement opportunities.
• Provide dashboards and reporting on Medicaid performance and risks for executive leadership.
• Lead cross-functional responses to Medicaid/audits and payer inquiries.

Skills

Medicaid expertise

Healthcare administration

Payer contracting

Leadership

Education

Master’s degree in business/healthcare/finance

Job description

SC Department of Behavioral Health and Developmental Disabilities (BHDD) seeks a Director of Managed Care to lead Medicaid and managed care activities. You will serve as Finance’s principal expert and liaison with SCDHHS, oversee enrollment, reimbursement, and revenue cycle operations, and coordinate cross-functional responses to payer issues.

The role requires a Master’s degree and substantial Medicaid experience, with leadership responsibilities and experience in behavioral health or large