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Moda Health · 1 day ago

Medicaid Strategic Operations Supervisor

Portland, OR

Full-time

Hybrid

Mid, Senior Level

$71K/yr - $88K/yr

4+ years exp

Moda Health is a healthcare company committed to quality and community support. The Strategic Operations Supervisor oversees Medicaid initiatives, manages escalated issues, and ensures compliance with regulations while identifying cost-saving opportunities.

BankingHealth CareHealth InsuranceInsurance

Responsibilities

Lead Medicaid cost-saving initiatives by analyzing, recommending, implementing, and tracking outcomes across internal departments and external entities

Develop and maintain departmental and executive dashboards and performance metrics, including identifying measurable KPIs for key priorities and initiatives

Articulate strategic visions and translate them into actionable initiatives, offering alternative pathways and solutions when needed

Provide strategic support on projects and deliverables of varying complexity and across stakeholder groups, incorporating feedback and pivoting direction or proposals as needed

Manage competing departmental priorities and coordinate data requests to ensure effective and timely execution

Recommend and implement policies and operational changes that support cost savings, process improvements, and future expansion efforts

Communicate data findings, insights, and strategic recommendations to department leadership, stakeholders, and executive teams

Stay current on and interpret state and federal legislation impacting Medicaid dollars and operations

Conduct local and national market research to identify opportunities for operational innovation

Ensure regulatory compliance while enhancing infrastructure and minimizing operational risk

Support third-party administrator (TPA) business accounts

Travel frequently to Eastern Oregon and other regions across the state

Perform other duties as assigned

Qualification

Oregon Medicaid experienceHealthcare operations knowledgeFinancial principles expertiseMicrosoft Office proficiencyProject management skillsAnalytical skillsCommunication skillsLeadership skillsAttention to detail

Required

Bachelor's degree in Business Administration, Finance, or a related field, required; Master's degree preferred

Minimum of 4 years of experience in Oregon Medicaid, healthcare operations, or regulatory compliance, with strong knowledge of financial principles and cost management

Proven ability to identify cost savings and implement operational improvements within healthcare systems

Experience with claims pricing, contract configuration, negotiation, and management, including the ability to identify and propose alternative strategies during complex negotiations

Strong project management, organizational, and analytical skills

Proficiency in Microsoft Office, with the ability to create effective reports and dashboards

Skilled in presenting data, proposals, and recommendations to executive leadership and diverse stakeholders

Excellent written, verbal, and interpersonal communication skills for effective cross-functional collaboration

Demonstrated situational awareness, emotional intelligence, and confident leadership in navigating complex or sensitive situations

Track record of innovation, adaptability, and collaboration in dynamic environments

High attention to detail, reliability, and consistent follow-through

Professional appearance and demeanor in all internal and external interactions

Must possess a valid driver's license