VP-Medicaid

VP-Medicaid Albuquerque, NM Job Details Full-time 13 hours ago Benefits Disability insurance Health insurance Dental insurance Flexible spending account Paid time off Vision insurance Life insurance Retirement plan Qualifications Managerial strategic planning Strategic management Government advocacy (outreach initiatives) Team development Health policy Quality improvement Mentoring Senior level Cross-functional team management Senior leadership

Full Job Description Location Address:

9521 San Mateo NE Albuquerque, NM 87113-2237

Summary:

Presbyterian Health Plan (PHP) seeks a visionary and strategic executive to serve as its VP, Medicaid. This is a pivotal leadership role designed for an individual who is passionate about serving the complex and diverse needs of Medicaid members and who possesses the sophistication to navigate the intersection of healthcare policy, state and federal regulation, and community-based care. As a national leader in Medicaid innovation, PHP is committed to designing programs that address the unique needs of New Mexicans—spanning rural, frontier, urban, and Native American sovereign communities. The VP, Medicaid will be the architect of this evolution, ensuring that the health plan remains a competitive, high-performing partner to the State of New Mexico and a tireless advocate for its most vulnerable populations. This position is open to remote applicants within the United States (excluding residents of CA, IL, ND, NY, OH, WA, and WY). For candidates residing in New Mexico and within 60 miles of a Presbyterian location, a hybrid schedule will be in effect to facilitate in-person collaboration and community engagement.

Job Description:

Executive Leadership:

Develop and execute strategic plans that meet the expectations of Medicaid members, state agencies, and federal regulators.

Thought Leadership:

Provide input on the State's strategy for achieving their vision, fostering alignment with Presbyterian's capabilities and new business models.

Matrix Management:

Lead functional teams across PHP (Network Contracting, Claims, Population Health, Pharmacy) without direct reporting lines to ensure seamless Medicaid service delivery.

Government Relations:

Engage fully in the government relations process to influence a positive perception of PHP's Medicaid program.

Market Surveillance:

Provide ongoing surveillance of national and state market shifts, including changes in Medicaid waivers and policy, to mitigate risk and inform strategy.

Quality & Health Equity:

Provide strategic direction for quality initiatives and performance measures while championing a culture of equity, diversity, and inclusion.

Team Development:

Build and lead high-performing teams, providing guidance and mentorship to foster a culture of accountability and innovation.

Additional Job Description:

Benefits Benefits are effective day-one (for .45 FTE and above) and include: Competitive salaries Full medical, dental and vision insurance Flexible spending accounts (FSAs) Free wellness programs Paid time off (PTO) Retirement plans, including matching employer contributions Continuing education and career development opportunities Life insurance and short/long term disability programs About Us Presbyterian Healthcare Services is a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, it is the state's largest private employer with approximately 11,000 employees. Presbyterian's story is really the story of the remarkable people who have chosen to work here. Starting with Reverend Cooper who began our journey in 1908, the hard work of thousands of physicians, employees, board members, and other volunteers brought Presbyterian from a tiny tuberculosis sanatorium to a statewide healthcare system, serving more than 700,000 New Mexicans. We are part of New Mexico's history - and committed to its future. That is why we will continue to work just as hard and care just as deeply to serve New Mexico for years to come. About New Mexico New Mexico's unique blend of Spanish, Mexican and Native American influences contribute to a culturally rich lifestyle. Add in Albuquerque's International Balloon Fiesta, Los Alamos' nuclear scientists, Roswell's visitors from outer space, and Santa Fe's artists, and you get an eclectic mix of people, places and experiences that make this state great. Cities in New Mexico are continually ranked among the nation's best places to work and live by Forbes magazine, Kiplinger's Personal Finance, and other corporate and government relocation managers like Worldwide ERC. New Mexico offers endless recreational opportunities to explore, and enjoy an active lifestyle. Venture off the beaten path, challenge your body in the elements, or open yourself up to the expansive sky. From hiking, golfing and biking to skiing, snowboarding and boating, it's all available among our beautiful wonders of the west.

AA/EOE/VET/DISABLED. PHS

is a drug-free and tobacco-free employer with smoke free campuses.