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Clinical Operations Director

Company: State of Indiana
Location: Indianapolis
Posted on: May 27, 2023

Job Description:

Clinical Operations Director
Date Posted: May 18, 2023
Requisition ID: 425536
Indianapolis, IN, US, 46202
Work for Indiana
Grow your career with the State of Indiana! With more than 50 executive branch agencies, the State of Indiana is a diverse workforce offering employees stimulating and challenging projects across a broad scope of career opportunities. As a State of Indiana employee, you impact the well-being of Indiana's communities every day.
At the State of Indiana, we don't just talk about diversity and inclusion - Our goal is to create a welcoming, accessible, and equitable workplace, with a workforce that is representative of the State of Indiana population. As a proud equal opportunity employer, reasonable accommodations may be available to enable individuals with disabilities to complete the application and interview process, as well as perform the essential functions of a role.
Next Level benefits at the State of Indiana are here! Be sure to review our expanded benefit package offerings below.
About the Family & Social Services Administration:
The Office of Medicaid Policy and Planning (OMPP) is a division within the Family and Social Services Administration, which receives around 13 percent of the state's budget to ensure vital health care coverage to approximately 1 in 5 Hoosiers. OMPP strives to build programs and processes that enable Hoosiers to live in fully engaged communities and reach their greatest emotional, mental and physical well-being. Our mission is to support individual and community well-being with effective and efficient programs, remarkable collaborations, measurable impact on individuals and communities, and an energized staff that is fully engaged with this mission.
Salary: This position traditionally starts at an annual salary of $140,010.00. Salary for this position may be commensurate with education and job experience.
About the Job:
This executive clinical operations role will provide leadership for the business and administration of clinical operations, matters related to policies, and our Managed Care Entity (MCE) partners. Your role will give organizational direction towards the utilization and implementation of evidence-based clinical protocols, policies, and procedures. As Director, you will also provide oversight to operations and projects within the division, including budgeting, contracts and program planning and implementation.
A Day in the Life:
--- Serves Medicaid programs and stakeholders to improve the member and provider experience as well as clinical outcomes.
--- Advises the Office of Medicaid Policy & Planning in all clinical activities and operations to include major responsibility for program design, development, implementation and evaluation.
--- Leads a diverse staff with responsibilities for coverage, medical & pharmeceutical policy and program management, utilization management, prior authorization, care management and coordination, quality improvement and managed care clinical policy and oversight.
--- Keeps abreast of emerging trends in health policy to ensure Medicaid has appropriate clinical care and coverage guidance.
--- Coordinates with Family & Social Services Administration division directors and Medical Directors to identify goals and objectives for Indiana Medicaid.
--- Identifies opportunities to collaborate and develop clinical integration initiatives with other stakeholders in the State to achieve effective and affordable outcomes.
--- Develops and conducts MCE clinical oversight and evaluation.
--- Develop culturally competent policies, programs and direction in medical coverage and benefits, pharmacy benefit management, care management, utilization management, and clinical quality improvement.
--- Leads, develops, directs, and implements clinical and non-clinical activities that impact health care quality and outcomes.
--- Hires, trains, coaches, counsels, and evaluates performance of direct reports and directly supervises the management of their assigned staff in clinical operations, including the Medical Directors.
What You'll Need for Success:
--- Degree in a clinical field (such as medicine, pharmacy, nursing, nutrition, and social work) from an accredited school, with board certification and license to practice in the State of Indiana without restriction as applicable.
--- A minimum of five years team leadership experience required; Preferred experience includes: managed care and/or health system experience, care management and utilization management experience; and familiarity with common healthcare quality metrics and processes including HEDIS and NCQA, and with pharmacy related programs.
--- Business operations expertise, including: budgeting; staffing and performance management; goal setting; vendor/contract management and implementation; and developing standard operating procedures; and project management;
--- Strong demonstrated transformational and complex, matrixed leadership skills (inspiring, problem solving, communication across multiple organizations, executing) to champion achieving the vision of the agency and division.
--- Strategic and innovative thinker with proven ability to communicate a vision and drive results.
--- Relies on extensive experience and judgement to solve problems, plan, and execute on initiatives.
--- Ability to translate clinical expertise into program and policy design for the improvement of the member and provider experience.
--- Ability to analyze and predict effects of program changes on actual work operations.
--- Ability to resolve issues with professionalism and sensitivity; must work well with other agencies, divisions, and consistently implement a unified vision.
--- Ability to communicate with excellence orally and in writing to diverse groups;
--- Ability to monitor program performance and evaluate.
--- Ability to use standard computer word processing, spreadsheet and database programs.
--- Must be analytical with keen ability to focus on detail while still focusing on the broader picture and message.
--- Ability to compile, synthesize, and present complex recommendations; and
--- Passion for public service.
Supervisory Responsibilities/Direct Reports:
This role provides direct supervision for one or more staff members.
Benefits of Employment with the State of Indiana:
The State of Indiana offers a comprehensive benefit package for full-time employees which includes:

  • Three (3) medical plan options (including RX coverage) as well as vision and dental plans

  • Wellness Rewards Program: Complete wellness activities to earn gift card rewards

  • Health savings account, which includes bi-weekly state contribution

  • Flexible work scheduling options, including the potential for hybrid remote work for employees whose work may be performed outside state facilities

  • Deferred compensation 457B account (similar to 401k plan) with employer match

  • Two (2) fully-funded pension plan options

  • A robust, comprehensive program of leave policies covering a variety of employee needs, including but not limited to:

  • 150 hours of paid new parent leave

  • Up to 15 hours of paid community service leave

  • Combined 180 hours of paid vacation, personal, and sick leave time off

  • 12 paid holidays, 14 on election years

  • Education Reimbursement Program

  • Group life insurance

  • Referral Bonus program

  • Employee assistance program that allows for covered behavioral health visits

  • Qualified employer for the Public Service Loan Forgiveness Program

  • Free Parking for most positions

  • Free LinkedIn Learning access

    Equal Employment Opportunity:
    The State of Indiana is an Equal Opportunity Employer and is committed to recruit, select, develop, and promote employees based on individual ability and job performance. Our policy is to provide equal employment opportunity to all people in all aspects of employer-employee relations without discrimination because of race, color, creed, religion, sex, national origin, ancestry, age, sexual orientation, gender identity, physical or mental disability, or veteran status. We will comply with the spirit as well as the letter of all applicable state and federal laws.
    If you are a qualified individual with a disability and require reasonable accommodation in completing this application, you can request assistance by contacting the Indiana State Personnel Department at [email -protected]
    The State of Indiana has established a culture that welcomes equity, inclusion, and opportunity for all employees and applicants. We encourage you to apply if you feel you have the transferrable skills to be successful in this position and we look forward to reviewing your application.
    Current Employee? Click here ( to apply.

Keywords: State of Indiana, Indianapolis , Clinical Operations Director, Executive , Indianapolis, Indiana

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