Job Details

SCOPE OF POSITION: 
Responsible for leading the development, delivery, and management of AFMC’s Outreach Services, Inspections of Care, and other related contracts and programs that support improved health outcomes for targeted populations. Ensures contract deliverables are met, promotes operational excellence, and collaborates with team members to educate health care providers and consumers and promote quality. Provides strategic leadership in translating complex Medicaid policies, program changes, and operational requirements into effective provider outreach, education, and engagement strategies. Works collaboratively with the Arkansas Department of Human Services, Medicaid program leadership, and other key stakeholders to support policy implementation, provider engagement, education, and operational improvements. Promotes AFMC’s programs and services to current and prospective stakeholders and serves as executive sponsor for outreach and quality efforts across AFMC. Selects, directs, coaches, and evaluates assigned staff. Demonstrates AFMC’s values of Honesty, Excellence, Accountability, Respect, and Teamwork in support of the organization’s mission and vision.

ESSENTIAL JOB FUNCTIONS:

1. Work with internal and external customers to develop, implement, and manage AFMC’s Outreach Services, Inspections of Care, and related contracts and programs that promote improved health outcomes in targeted patient populations.
2. Develop relationships and promote mutually beneficial partnerships with clients, key stakeholders, constituents, other healthcare organizations, and the community at large.
3. Identity opportunities for AFMC to improve health and human services in Arkansas and other states through community engagement, research, policy and program development.
4. Establish and maintain strategic working relationships with Arkansas Department of Human Services leadership, Medicaid program administrators, healthcare providers, managed care organizations, and other key stakeholders to support effective program coordination, policy implementation, and provider engagement.
5. Monitor, interpret, and evaluate changes in state and federal Medicaid policies, regulations, program requirements, and operational guidance. Assess the implications for healthcare providers, outreach activities, contractual responsibilities, and AFMC operations, and provide strategic recommendations to executive leadership. 
6. Maintain knowledge of specialized Medicaid programs, including home and community-based services, waiver programs, long-term services and supports, and other programs serving individuals with complex healthcare and support needs. Evaluate policy and operational developments affecting provider outreach and education.
7. Identify emerging Medicaid policy issues, program developments, provider concerns, and operational challenges that may impact AFMC's contracts, programs, organizational strategy. Recommend appropriate operational and strategic responses to executive leadership.
8. Oversee the development and delivery of outreach presentations, informational materials, and educational programs to support provider participation in projects. Promote continuous quality improvement principles and tools and develop feedback strategies for the provider community.
9. Monitor departmental performance against established objectives and timelines, and implement corrective actions when results are not on track.
10. Prepare and submit required monthly, quarterly, and annual departmental reports to the COO and CEO.
11. Prepare annual departmental budget. Analyze and control expenditures of department to conform to budgetary requirements. 
12. Meet regularly with executive management to advise on organizational goals, objectives, and policies and obtain direction or support for cross-departmental priorities.
13. Select, direct, train, coach, and evaluate assigned staff. Establish performance standards and annual objectives, monitor progress, and hold staff accountable for accurate, timely work.
14. Provide executive sponsorship and strategic direction for provider outreach and quality efforts across AFMC.
15. Identify and pursue opportunities for new or expanded business.
16. Additional duties as assigned.

KNOWLEDGE, SKILLS, AND ABILITIES:

• Strong leadership skills with the ability to lead, develop, and motivate teams.
• Ability to develop and implement strategic and operational plans aligned with organizational goals.
• Excellent written, verbal, presentation, and public speaking skills.
• Strong relationship-building skills with the ability to collaborate effectively with clients, business partners, community organizations, stakeholders, and the public.
• Knowledge of applicable contract requirements, regulations, and industry standards.
• Ability to analyze operational and performance data and use results to support decision-making and continuous improvement.
• Strong project management, organizational, and problem-solving skills.
• Ability to manage multiple priorities, delegate effectively, meet deadlines, and maintain accountability for results.
• Demonstrated initiative, sound judgment, creativity, flexibility, and professionalism.
• Ability to work collaboratively across departments and with executive leadership.
• Strong customer service and stakeholder engagement skills.
• Ability to maintain confidentiality and appropriately manage sensitive information.
• Proficiency with Microsoft Office and other business technology.
• Knowledge of health care terminology, coding concepts, and data standards relevant to assigned outreach programs.
• Knowledge of health information technology and electronic health record systems relevant to provider outreach and program operations.
• Ability to travel, including overnight travel, as needed.
   

Required:

• Minimum of ten (10) years of professional experience in Medicaid programs, healthcare administration, managed care, healthcare policy, provider relations, or related healthcare operations.
• Minimum of five (5) years of senior leadership and managerial experience, including responsibility for program strategies, operational oversight, staff management, and budgets. 
• Demonstrated experience interpreting, implementing, and supporting state Medicaid policies and programs, including evaluating their impact on healthcare providers, provider outreach, education, and program operations.
• Experience working directly with state Medicaid agencies or comparable government entities on Medicaid program administration, policy implementation, or provider-related initiatives.

Desirable:

• Extensive knowledge of Arkansas Medicaid programs, policies, and operations.
• Experience overseeing multiple state or federal healthcare programs and leading cross-functional initiatives involving policy, operations, and provider engagement.
• Experience contributing to strategic planning, program development, and business development activities within a healthcare organization.

EDUCATION:
Required: Bachelor’s degree.
Desirable: Masters, PhD, Juris Doctorate, or other advanced degree in a related field.

INTERNET REQUIREMENTS:
Reliable, high-speed wireless internet service (Wi-Fi)

Physical and Sensory Requirements (With or Without the Aid of Mechanical Devices):
Mobility, reaching, bending, lifting, grasping, ability to read and write ability to communicate with personnel, ability to remain calm under stress. Must be capable of performing the essential job functions of this job, with or without reasonable accommodations.