DescriptionHumana's South Carolina Medicaid State Market Leader will be responsible for the overall strategic direction, oversight, and administration of programs and services for our Medicaid program in South Carolina. They will lead the Humana South Carolina Medicaid executive team and report directly to Humana's SVP, Medicaid Divisional President. The State Market Leader will be based in South Carolina and will be the primary contact for the South Carolina Department of Medicaid Services regarding all issues and will coordinate with other key personnel to fulfill programmatic requirements. They will publicly represent Humana Medicaid in South Carolina while enhancing and further developing relationships with stakeholders throughout the state.
Responsibilities
Manage executive Medicaid leadership team in the South Carolina market, through which all plan associates report.Develop strategies, formulate policies, and oversee operations to ensure the appropriate objectives and goals are met.Represent Humana to the public, to plan members, to associates, to South Carolina Department of Medicaid Services, and to subcontractors.Drive a focus on the delivery of high-quality care and supports.Develop clear and measurable plan objectives, goals, and ideas.Establish and maintain a diverse, inclusive, and respectful environment.Promote a culture of health and well-being throughout the organization.Ensure plan compliance with federal and state laws and programmatic requirements, including fraud, waste, and abuse; make decisions in an ethical manner.Oversee operational policies and procedures.Ensure long-term health plan financial success, sustainability, and growth.Develop and adhere to budgets.Resolve urgent and emergency matters in a fair way according to applicable policies and procedures.Work with Humana National support teams to infuse best practices from other states and drive new ideas and initiatives from across the Medicaid and healthcare industry.Effectively support the growth of associates to enhance plan leadership and career development.Serve as chairperson of the Member Advisory Council.Required
Bachelor's degree in Business, Healthcare Administration, or related field.SC residence.Preferred Experience Qualifications
Experience in Medicaid MCO plan operations; experience in strategic and thought leadership in supporting Medicaid health plans; experience with budgeting and financial management of a health plan.Six (6) to ten (10) years of experience working in healthcare or government leadership and/or operations management.Leadership background with more than five (5) direct-reports.Master's degree in Business, Healthcare, Public Health, or related field.Experience working with Long Term Care Services and Support (LTSS).Additional Information
Ability to go into the office as business requires.Travel 25%.This is a remote position.Scheduled Weekly Hours: 40Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services.
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