Medicaid & CHIP Operations Director — Remote/Hybrid

State of Washington; Olympia (WA); Hybrid; USD 150,000 - 210,000; Full time

Benefits offered by this job

Free parking

Mobile work options

Great total compensation and benefits

Job summary

State of Washington, Health Care Authority, seeks an Apple Health Services and Operations Director to lead the AHSO division, guiding 65 statewide Medicaid, CHIP, and state-funded programs serving 1.9 million residents. This division shapes policy interpretation and operational leadership across customer and provider services.

This remote-hybrid role reports to the Medicaid and CHIP Director and oversees COB and claims processing, authorization services, and related operations; onsite attendance

Qualifications

• Bachelor’s degree in health policy, health administration, public health, public administration, or related field.
• Seven (7) years of leadership experience in Medicaid, public health, human services, program administration, health policy, or related programs, projects, teams, or operations in a represented environment, and three (3) years of senior level management experience.

Responsibilities

• Direct statewide customer and provider service operations for Medicaid, CHIP, state-wide medical assistance programs, and the WACares Program.
• Establish strategic direction, priorities, performance measures, and operational objectives for AHSO units.
• Ensure operational excellence and lead enterprise-wide initiatives to improve customer service delivery, provider support, and claims administration.
• Ensure operational readiness for major program, policy, and systems changes.
• Provide executive oversight and direction for Medicaid program administration, compliance, and policy interpretation, operationalization, and compliance.
• Address federal and state statutes, regulations, CMS guidance, audit findings, and program requirements related to Medicaid prior authorization, coordination of benefits, and provider enrollment.
• Direct the design, implementation, and evaluation of state Medicaid Coordination of Benefits (COB) and Third-Party Liability (TPL) policies to ensure regulatory compliance.
• Advise the Medicaid Director and Executive Leadership regarding operational impacts of policy, legislative, fiscal, and regulatory changes.
• Serve as appointing authority for a workforce of 250 employees, both represented and non-represented, through senior leaders and front-line supervisors.
• Exercise authority for personnel decisions in accordance with state laws, collective bargaining agreements, civil service rules, and agency policy.
• Direct division budget planning, resource allocation, and fiscal accountability.

Skills

Leadership

Policy interpretation

Strategic direction

Education

Bachelor’s degree in health policy/health administration/public health

Associate degree in health policy/health administration/public health

Nine years leadership experience in Medicaid/public health (represented environment)

Job description

State of Washington, Health Care Authority, seeks an Apple Health Services and Operations Director to lead the AHSO division, guiding 65 statewide Medicaid, CHIP, and state-funded programs serving 1.9 million residents. This division shapes policy interpretation and operational leadership across customer and provider services.

This remote-hybrid role reports to the Medicaid and CHIP Director and oversees COB and claims processing, authorization services, and related operations; onsite attendance