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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in leading Medicaid enrollment and waiver modernization initiatives, with a strong focus on process improvement, operational oversight, and stakeholder alignment. Proficient in analyzing business processes and implementing scalable solutions that enhance data accuracy and operational efficiency.
Highest-signal resume keywords
Medicaid Enrollment ManagementProcess Improvement LeadershipCross-Functional Project ManagementRisk ManagementData Analysis and Reporting
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Business Process AnalysisRequirements DevelopmentOperational Process ImplementationTesting Strategy DevelopmentFinancial Data InterpretationHealthcare Initiative LeadershipChange ManagementAutomation IdentificationPerformance MeasurementWaiver Data Accuracy Improvement
Soft Skills
Analytical Problem-SolvingStakeholder CommunicationInfluencing Executive LeadershipFacilitating AlignmentTeam Collaboration
Tools & Technologies
Microsoft ExcelPower BIData Reporting ToolsProject Management SoftwareCollaboration Platforms
Industry Keywords
Medicaid Managed CareEligibilityWaiver AdministrationMember AdministrationLTSS Waiver Processes
About the role
Key responsibilities & impact- Analyze and measure the effectiveness of existing business processes
- Develop sustainable, repeatable, and quantifiable business process improvements
- Provide business ownership and leadership for strategic Medicaid enrollment and waiver modernization initiatives
- Lead enterprise member movement enhancements
- Define requirements, conduct testing, validate results, and support implementation with IT and business stakeholders
- Identify operational risks and develop solutions minimizing impacts to clinical, claims, finance, and enrollment operations
- Monitor post-implementation performance and business outcomes
- Provide operational ownership and oversight for multiple Medicaid waiver enhancements
- Govern LTSS waiver-related processes, updates, validations, and issue resolution
- Manage the LTSS mailbox and coordinate review, validation, and processing of waiver-related member information
- Develop scalable processes that reduce manual intervention and improve waiver data accuracy
- Liaise across business operations, technology, finance, claims, clinical, and enrollment teams
- Facilitate stakeholder alignment on priorities, requirements, testing, implementation, and operational readiness
- Communicate project progress, risks, dependencies, and recommendations to leadership
- Support training, change management, and adoption efforts
- Identify automation opportunities and establish monitoring, reporting, and governance practices
- Support enterprise Medicaid operations and enrollment modernization initiatives
Requirements
What you’ll need- Experience leading complex healthcare, Medicaid, process improvement, operational, or technology initiatives
- Demonstrated success managing cross-functional projects involving multiple business areas
- Strong analytical, problem-solving, and risk management capabilities
- Experience developing business requirements, testing strategies, operational processes, and implementation plans
- Medicaid managed care, enrollment, eligibility, waiver, or member administration experience preferred
- Experience with Medicare and/or Medicaid preferred
- Experience with Medicare Reconciliation preferred
- Experience analyzing, interpreting, and displaying financial, health, competitive, and performance measurement data preferred
- Experience leading strategy and/or operational planning preferred
- Experience consulting to, and/or influencing, executive leadership preferred
- Experience influencing change in a matrix organization preferred
- Experience with Microsoft Excel chart creation, macros, and pivot tables preferred
- Experience with Power BI preferred
- Minimum home internet speed of 25 Mbps download and 10 Mbps upload for home or hybrid home/office employees
- Ability to work from a dedicated space without ongoing interruptions to protect member PHI/HIPAA information
Benefits
Comp & perks- Bonus incentive plan based upon company and/or individual performance
- Medical benefits
- Dental benefits
- Vision benefits
- 401(k) retirement savings plan
- Paid time off
- Company holidays
- Personal holidays
- Paid parental leave
- Paid caregiver leave
- Short-term disability
- Long-term disability
- Life insurance
- Personal wellness support and smart healthcare decision resources