Strategic Director, Managed Care Operations (Hybrid)

State of Tennessee; Nashville (TN); Hybrid; USD 140,000 - 190,000; Full time

Job summary

TennCare is seeking a Director of Managed Care Operations to lead the executive team and provide strategic direction for the managed care delivery system. The role focuses on contract oversight, program integrity, and performance excellence across TennCare's MCOs.

The Director will manage approximately 36 employees across four teams, drive continuous improvement, and collaborate with agency leadership to advance TennCare's strategic priorities and operational performance.

Qualifications

• 5+ years of relevant professional experience in budget, finance, health care, government, or related areas.
• Equivalent combination of education and work experience may be considered in place of degree.
• Demonstrated ability to lead cross-functional teams and manage complex programs.
• Strong organizational skills with the ability to prioritize and meet tight deadlines.
• Experience with Medicaid or state government programs is preferred.

Responsibilities

• Provide strategic direction for Managed Care Operations (MCOps) and TennCare's executive leadership team.
• Oversee contract oversight, program integrity, and performance metrics for MCOs.
• Lead high-profile, cross-functional initiatives to improve operational performance.
• Translate data into actionable insights for executive decision-making.
• Develop and monitor performance goals and dashboards for key MCO activities.
• Manage a large, multi-team organization and foster a high-performing culture.
• Represent TennCare in interactions with legislators, providers, and stakeholders.

Skills

Analytical thinking

Oral and written communication

Project management

Leadership

Education

Bachelor's degree in business, finance, public administration, public health, public policy, or related field

Job description

TennCare is seeking a Director of Managed Care Operations to lead the executive team and provide strategic direction for the managed care delivery system. The role focuses on contract oversight, program integrity, and performance excellence across TennCare's MCOs.

The Director will manage approximately 36 employees across four teams, drive continuous improvement, and collaborate with agency leadership to advance TennCare's strategic priorities and operational performance.