Northeast Florida Area Agency on Aging D/B/A ElderSource – Executive Director of Medicaid Management Services (MMS)

Posted Sep 22, 2022 Jacksonville, Florida

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Expires Oct 21, 2022

Description

Summary
The Executive Director of Medicaid Management Services (MMS) will be the foundational role of the company leading the organization’s overall strategic efforts. The position is responsible for the overall administrative management and operation of the company. The Executive Director will work collaboratively with the MMS Board of Directors, providers, hospitals, health plans, and other exceptional groups or individuals who strive to improve the lives of older adults and adults living with disabilities. MMS is seeking a person who is committed to advancing the mission with energy and passion. This position reports directly to the Board of Directors. This position will work remotely most of the time.

Critical features of this job are described under the headings below. They may be subject to change at any time due to reasonable accommodation or other reasons.

Essential duties and responsibilities

Essential Duties and Responsibilities include the following. Other duties may be assigned. A. Work with the Board of Directors and ElderSource leadership to conduct strategic planning with the development of short and long-range plans and goals in an effort to establish Community Integrated Health Networks to address social determinants of health. B. Develop operational policies, procedures, and processes to implement the activities of the company. C. Plans, directs and coordinates the activities of the company and ensures policy formulation and implementation is consistent with overall agency policies and objectives. D. Develop and manage contract processes, tools, and reviews. E. Identify, review, and assess risks related to state and federal laws, rules and regulations, and related policies that may govern the services provided by the CIHN. F. Conduct regular risk assessments related to planning, contracts, and insurance G. Establish, plan, and direct a continuous quality improvement process to ensure compliance with contracts and agreements. H. Establish, develop, and maintain effective working relationships with health care sector organizations (i.e. hospitals, health systems, health plans, accountable care organizations, managed care organizations, providers, State and other Area Agencies on Aging and Aging and Disability Resource Centers, etc.). I. Develop and maintain a CIHN to include vetting, onboarding, support, and oversight of providers. J. Demonstrate leadership of the CIHN to establish cohesive and supportive network of providers K. Establish CIHN vision and create network culture that adapts quickly to changing health care environment L. Develop and deploy regular CIHN trainings M. Conduct regular meetings with CIHN members to educate CIHN members on current market to develop culture and expectations of the network to be able to adjust to changing market / buyer demand N. Develop training materials for Executive Director, C-suite, and/or Board of Directors to establish baseline knowledge of industry and current trends, specific to NLE and CIHN network topics (e.g., social determinants of health (SDoH), Medicare Advantage plans, Accountable Care Organizations, etc.) O. Establish and enforce minimum standards and criteria for services and network participation. P. Monitors the adequacy of the company’s activities through coordination with the board and enacts policies to assure excellent health care services and network management. Q. Assures the sound fiscal operation of the company including timely, accurate, and comprehensive development of an annual budget and its implementation. R. Ensures compliance with the regulations of governmental entities, health plans, hospitals, and the rules of accrediting bodies by continually monitoring the organization's service delivery and initiating changes as required. S. Negotiates contracts with health care sector organizations and providers and ensure compliance with those contracts. T. Direct and coordinate studies to evaluate emerging health care policies, programs, and market trends to encourage and establish contracting opportunities. U. Develop revenue growth strategies that utilize innovative payment models, creative funding sources, and financial risk assessments. V. Plan for the efficient and effective use of program resources. W. Directs the preparation of an annual budget including developing the overall estimates and rationales for program activities and changes. X. Direct expenditures of the company’s budget consistent with goals and objectives, revenue strategies. Y. Serves as spokesperson and advocate for the company and CIHN. Z. Meets and confers with Federal, State, and local officials, the Area Agency on Aging Advisory Council, the Aging and Disability Resource Center and other members of the network and public. AA. Ensures that an appropriate and effective process to allocate, monitor and account for funds is in place, and meets acceptable standards BB. Create transition staffing plan and periodically evaluate organization structure (including position descriptions and salary) ranges. Make recommendations within constraints of available funding and marketplace requirements (in conjunction with the senior management staff). CC. Creates public awareness of the needs, problems, and opportunities of the area's older population, including the availability of the Aging Resource Center. DD. Provides leadership to the Board of Directors to identify new sources of funding which may include grants, new services, and other local government support. EE. Meets and supports the MMS Advisory Committee to seek their input on network and community needs and performance of the CIHN. This job description reflects management's assignment of essential functions; it does not prescribe or restrict the tasks that may be assigned. Supervisory Responsibilities: Responsible for the overall administrative management and operation of the company and network. Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws.

Qualifications

To perform this job successfully, this position must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Other Skills and Abilities A. Knowledge of Federal and Grant management process. B. Knowledge of various social programs for the elderly and the impact of social determinants of health. C. Knowledge of health networks and health systems. D. Knowledge of payment models. E. Ability to manage a provider network F. Ability to negotiate with plans and other health system payers and providers

Education and Experience

A Bachelor’s Degree or fifth year college or university program certificate; Education must be in the field of Health, Health Administration, Business, Public Health or other related field; seven or more years of related experience and/or training; and/ or four to ten years of work experience in health, social services, program management, including at least three at the supervisory level. Experience must include responsibility for budget preparation and management. Any exception to the degree requirements must comply with current regulation and must be approved by the Board of Directors. Other Skills and Abilities A. Knowledge of Federal and Grant management process. B. Knowledge of various social programs for the elderly and the impact of social determinants of health. C. Knowledge of health networks and health systems. D. Knowledge of payment models. E. Ability to manage a provider network F. Ability to negotiate with plans and other health system payers and providers

Salary/Salary Range

$75,000 to $85,000 Annually (Depending on experience)

Company/Organization

Northeast Florida Area Agency on Aging D/B/A ElderSource

http://www.myeldersource.org

Contact

Bernadette Brown | Email