Executive Director of Medicaid Operations - 24729

Company: New York City Department of Education
Location: New York
Posted on: February 2, 2025

Job Description:

Position Summary: New York City Public Schools (NYCPS), the largest school system in the country with over 1 million students and 150,000+ employees in more than 1,800 schools, seeks an Executive Director of Medicaid Operations. This role involves overseeing and managing NYCPS's Medicaid claiming program and providing strategic support to the Office of the Chief Financial Officer (CFO) to maximize reimbursements. The Executive Director will lead the business and scheduling offices in developing new workstreams and processes and oversee NYCPS's analytical work on key policy issues affecting Medicaid and the State Children's Health Insurance Program (CHIP).Working under the direction of the Office of the CFO, the Executive Director is expected to conceptualize and manage significant projects, often involving other team members. The selected candidate will play a crucial role in ensuring the efficiency and effectiveness of Medicaid claims and reimbursements, contributing significantly to the overall mission of NYCPS, supervising Medicaid's Data Analytics and Scheduling teams, and streamlining policies and procedures to enhance Medicaid claims and reimbursements.Responsibilities:

• Lead the planning, evaluation, and implementation of the organization's Medicaid claiming process.
• Demonstrate knowledge of state and federal Medicaid and CHIP policy and program issues.
• Apply critical thinking and policy analysis skills to construct arguments, use evidence, and translate findings into clear priorities and actions.
• Manage project teams, including project planning, balancing multiple responsibilities, supervising team quality, and serving as project officer for external contracts.
• Continue developing new knowledge and skills, seek specialization opportunities, and respond to feedback from supervisors and colleagues.
• Identify and fill gaps in staff knowledge and skills, provide technical reviews and constructive feedback, and expand productive working relationships with peers and external organizations.
• Leverage strategic partnerships with external stakeholders to maximize reimbursements.
• Represent the team and Division of Finance in ensuring NYCPS's new special education data system meets Medicaid claim requirements.
• Oversee management of electronically stored and transmitted Medicaid claiming support items (e.g., Parental Consent, Prescriptions).
• Ensure vendor software is up-to-date with Medicaid requirements per NYS regulations and report to the CFO Office.
• Collaborate with partner Agencies on systems integration for claiming.
• Make policy recommendations for CFO approval and suggest policy directions for the state legislative agenda.
• Represent and coordinate with external stakeholders to align Medicaid policy across NYS urban school districts.
• Maintain knowledge of regulatory guidelines and recommend operational changes as needed.
• Lead the creation and implementation of the new Medicaid claiming and management system (MedSys).
• Make recommendations to the Deputy CFO on the outcomes of analytical initiatives, including policy changes and improved internal processes.
• Serve as the primary liaison to NYS-approved non-public schools, ensuring utilization of Medicaid software and proper documentation of services.
• Oversee contracting processes with new vendors, ensuring adherence to NYCPS regulations and best practices.
• Develop and implement fiscal management strategies, including recorded tracking of funds, policies, and procedures.
• Maximize agency's reimbursement by ensuring compliance and recommending policy changes that may lead to additional funding.
• Develop and implement policies and standards; oversee staff selection, and provide training and support to all relevant stakeholders.
• Provide technical assistance and financial information to respond to internal and external inquiries.Qualification Requirements:Minimum:
  • A Baccalaureate degree from an accredited college or university in public administration, business administration, education administration, personnel administration, management or a related field and four years of satisfactory, responsible, full-time experience in any of the above areas or in another area of specialization applicable to the position, at least 18 months of which must have been in an administrative, consultative, managerial or executive capacity; or
  • Education and/or experience equivalent to "1" above. However, all candidates must possess the 18 months of administrative, consultative, managerial or executive experience as described above.Preferred:
    • Knowledge and expertise in Medicaid access to coverage and care policies.
    • Strong strategic analysis, planning, operational, and project management skills.
    • Familiarity with NYS Medicaid policy for the School Supportive Health Services Program.
    • Advanced data analytics skills.
    • Excellent written and spoken communication skills, including public speaking.
    • Strong detail orientation and organizational skills.
    • Ability to manage multiple projects under tight deadlines.
    • Experience facilitating large meetings and discussions.
    • Strong interpersonal skills and customer service orientation.
    • Management or strategy consulting experience.
    • Problem-solving skills with the ability to perform independent analysis.
    • Proficiency in Microsoft Office applications, including Excel, Access, and PowerPoint.Please include a resume and cover letter with your application.NOTE: The filling of all positions is subject to budget availability and/or grant funding.*New York City Residency is NOT Required*We encourage all applicants from the New York City tri-state area to apply.AN EQUAL OPPORTUNITY EMPLOYERDOE Non-Discrimination Policy: The Department of Education of the City of New York is an inclusive equal opportunity employer committed to recruiting and retaining a diverse workforce and providing a work environment that is free from discrimination and harassment upon any legally protected status or protected characteristic.Public Service Loan Forgiveness: As a prospective employee of the City of New York, you may be eligible for federal loan forgiveness programs and state repayment assistance programs. For more information, please visit the U.S. Department of Education's website.
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Keywords: New York City Department of Education, Mount Vernon , Executive Director of Medicaid Operations - 24729, Executive , New York, New York