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Acentra Health

Modernizes public healthcare with claims solutions

Program Director - NY Medicaid Provider Services

Program ManagementPosted on Nov 3
Full-time$145.2k - $210k /yr

About the Job

Requirements

  • A bachelor's degree in business, healthcare administration, information technology, project management, or a related field is preferred.
  • At least 7 years of experience managing complex healthcare, Medicaid, government, or technology programs of similar size and scope.
  • At least 10 years of experience in managerial and leadership roles.
  • Demonstrated experience managing the full system development life cycle, including planning, requirements, design, configuration, testing, implementation, stabilization, and operations.
  • Experience managing provider enrollment, provider management, Medicaid Enterprise Systems, MMIS, or other healthcare administration programs.
  • Demonstrated experience managing client relationships, contractual obligations, deliverables, budgets, risks, issues, staffing, and performance metrics.
  • Experience working in a multi-vendor environment and coordinating with government agencies, system integrators, and other implementation partners.
  • Demonstrated ability to lead cross-functional teams in a high-visibility, time-sensitive environment.
  • Ability to pass required background checks and comply with applicable privacy, security, HIPAA, and data-access requirements.
  • Ability to support operational readiness activities, user acceptance testing, implementation, production deployment, and other client-required activities.
  • Ability and flexibility to travel to onsite meetings and client sites as needed.

Responsibilities

  • Maintain accountability for applicable contractual service-level agreements, including system functionality, staffing levels, issue resolution, reporting, and operational readiness.
  • Coordinate cross-functional teams across provider enrollment operations, business analysis, project management, technology, testing, conversion, training, certification, architecture, and production support.
  • Lead the transition from development and implementation into steady-state operations, ensuring readiness, staffing, procedures, documentation, and support processes are in place.
  • Identify, assess, and resolve operational challenges; escalate issues and coordinate timely solutions with internal teams, the client, and vendors.
  • Establish and maintain risk, issue, dependency, change, escalation, and decision-management practices.
  • Lead implementation planning, operational readiness, go-live preparation, stabilization, continuous improvement, and transition planning.
  • Support CMS certification, MECT milestone reviews, independent verification and validation activities, certification artifacts, audit readiness, and remediation activities as required.
  • Oversee workforce planning and resource allocation to maintain qualified personnel and sufficient staffing for contractual and operational requirements.
  • Prepare and present status reports, executive briefings, performance reviews, financial updates, and other program communications for internal leadership and client stakeholders.
  • Develop and implement methods, procedures, and service-improvement initiatives to improve provider and user experience, operational efficiency, quality, and program outcomes.
  • Provide guidance and oversight to team members and functional leads responsible for program areas or delivery phases.
  • Collaborate with Business Development and organizational leadership on client growth, new business opportunities, expansions, and related proposals as requested.
  • Ensure compliance with corporate policies, HIPAA and HITECH requirements, CMS requirements, applicable state and federal regulations, security and privacy standards, and contractual obligations.

Desired Qualifications

  • Project Management Professional or other PMI certification.
  • A master's degree.
  • Knowledge of CMS certification, MECT/SMC, independent verification and validation, Medicaid regulations, HIPAA, and applicable state and federal requirements.
  • Knowledge of best practices in healthcare operations.
  • Knowledge of metrics, productivity measures, and reporting.
  • Knowledge of contract development and implementation.
  • Budget and financial skills.
  • Written, verbal, and listening communication skills, including appropriate interpersonal skills with a variety of stakeholders.

About the Company

Acentra Health

Modernizes public healthcare with claims solutions

Acentra Health helps public-sector health programs run better by combining deep knowledge of government health programs with clinical expertise and technology. It designs and delivers software and services for claims, encounter, and provider data to improve processing efficiency and reduce costs, while offering care-management and quality-oversight services that focus on clinically informed decision making. Its products connect providers, payers, and government agencies to streamline workflows and oversight across state and federal programs. The company differentiates itself through its blend of public-sector know-how, clinical focus, and technology, accelerated by the backing of Carlyle, with a goal of delivering measurable outcomes for priority populations. Overall, Acentra Health aims to improve health outcomes, increase program efficiency, and lower costs for government healthcare programs.

Company size
1,001-5,000
Company stage
Not listed
Total funding
Not listed
Headquarters
McLean, VA
Founded
2023

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