Program Manager V, Medicaid Chief Information Officer

Overview :

Reporting to the Executive Director of Maryland HealthChoice, the Program Manager V is a key leader of KP’s Regulatory Reporting and Technical alignment with the Maryland HealthChoice program. The Program Manager is responsible for regulatory reporting, Medicaid IT contractual requirements, and encounter submissions. The role also requires Medicaid Health Plan experience, familiarity with KP technology systems, and expertise in membership enrollment, claims processing, and regulatory state reporting.

Job Summary :

Manages large-scale programs or components with multiple workstreams and strategic business goals across departments, functions, or regions with responsibility and accountability for achieving program outcomes from initiation to close-out in an extended or open-ended time frame. Leads the work of large program teams by coordinating and monitoring internal and / or external resources. Proactively monitors, identifies, and mitigates program risks, issues, and trigger events by developing mitigation plans and strategies. Monitors compliance of program activities by ensuring program plans and team members adhere to relevant policies and procedures. Ensures the alignment, buy-in, engagement, and support of diverse program stakeholders. Reviews vendor performance levels, ensures service level agreements are met, and participates in contract negotiations with vendors.

Essential Responsibilities :

• Promotes learning in others by communicating information and providing advice to drive projects forward; builds relationships with cross-functional stakeholders.
• Conducts or oversees business-specific projects by applying deep expertise in subject area; promotes adherence to all procedures and policies.
• Develops, analyzes, and manages highly complex program plans which include scope identification and management, schedule, inter-dependencies, and resource forecast.
• Leads the work of large program teams by monitoring internal and external resources and communicating a clear vision of program goals and objectives to the team.
• Proactively monitors, identifies, and mitigates program risks, issues, and trigger events by developing mitigation plans and strategies.
• Monitors adherence of program activities to policies and procedures by ensuring program plans and team members follow KP, departmental, and / or business line policies and procedures.
• Ensures the alignment, buy-in, engagement, and support of diverse program stakeholders by building and maintaining relationships.
• Reviews vendor performance levels and ensures service level agreements are met; participates in contract negotiations with vendors.

Minimum Qualifications :

Additional Requirements :

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