Medicaid Contract Liaison-Must live in Michigan

Job DescriptionServes as primary liaison for MDHHS Medicaid program. Accountable for the development, implementation and ongoing management of more complex projects which typically impact more than one of the following: process, system, product and/or function and may run a year in duration. Serves as Medicaid contract expert and leads configuration sessions related to managed care benefits/claims/enrollment and other operational components. Works directly with MDHHS and attends requisite regulatory meetings for operations/configuration planning as Medicaid Liaison.Required QualificationsMUST LIVE IN MICHIGAN-willing to travel 10% of time within the state-Develops and implements strategic project plan to achieve business goals-Proactively leads project and/or business by setting direction of project, creating project plan, timeline identifying key milestones and additional resources needed on selected project(s) Identifies gaps and recommends enhancements related to new and/or existing products, services and workflows based on broad view of the organization -Solicits and evaluates internal and external customer feedback to enhance continuous quality improvement-Responsible for managing the budget and/or financial implications of more complex projects -Group facilitation/presentation influencing various internal (these may be cross-functional/segment) and external parties (e.g., vendor management) Identifies issues that may stall project and addresses them by either resolving the issue or creating an alternative solution -Tracks progress and communicates project(s) status on a regular basis to all impacted parties Builds communication plans for implementation to ensure all impacted parties (up stream/down stream) are informed of next steps for completion-Manage cross functional teams and implementing Medicaid managed care requirements -Acts as an advocate for change may require influencing others to see the value in project, including managing interpersonal sensitivities and articulating the strategic view to ensure project alignment-Strong understanding of managed care health plan operations and regulations, inclusive of claims/configuration and business requirements-Prior MI Medicaid managed care health plan experience -Ability to communicate effectively with all levels of management-Strong understanding of compliance/legal interfaces relative to Medicaid regulatory requirements- 5-7 years of management experience related to standards & measurements, technology, systems, processes etc. preferredCOVID RequirementsCOVID-19 Vaccination RequirementCVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.Preferred Qualifications-Experience working on Michigan Medicaid initiatives/projects/regulatory requirements-Solid Project Management and supervisory skills-Strong analytic ability to translate Medicaid policies into managed care operation protocols (i.e. claim configuration reporting requirement etc.).-Proven ability to affect change/interpersonal skills-Past positions required acting a project lead and directing a team-Past experience includes development of budgets-Proven communication skills both written and verbal-Proven track record in meeting project milestones and negotiating for resources-Experience working on Michigan Medicaid initiatives/projects/regulatory requirements#LI-KS2EducationBS/BA or equivalent experienceBusiness OverviewAt Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

Created: 2025-10-04