Project Director - Medicaid

Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed care organization quality review, and quality assurance for programs serving individuals with developmental disabilities. Qlarant is also a national leader in fighting fraud, waste and abuse for large organizations across the country.

Best People, Best Solutions, Best Results

Job Summary:

Plans, directs, and coordinates activities of designated project(s) to ensure that goals or objectives and contract requirements of project are accomplished within prescribed time frame and funding parameters by performing the following duties personally or through subordinates.

Essential Duties and Responsibilities include the following. Other duties may be assigned.

• Maintains knowledge of project proposal or plan and provides technical oversight to all phases of project. May contribute to proposal development.
• Provides oversight of contractual requirements; maintains working knowledge of customer needs and contract requirements, deliverables, resource requirements, budget management; monitors and adheres to cost projections, and continuously explores operational efficiencies. Ensures systems are in place for contract compliance and timely deliverables. Develops and works with others to utilize management tools to monitor contract performance.
• Coordinates with Management to ensure the staff has clear direction of the objectives required; Confers with project staff to outline work plan and to assign duties, responsibilities, and scope of authority. Confers with project personnel to provide technical advice and to resolve problems; Directs and coordinates activities of project personnel to ensure project progresses on schedule and within prescribed budget. Reviews status reports prepared by project personnel and modifies schedules or plans as required.
• Prepares written reports, articles for publication, and requests for proposals/grants.
• Conducts meetings of all types, i.e., focus groups and provider meetings, and participates on committees.
• Works with the government contract oversight coordinator to ensure all aspects of the contract are met as specified in the SOW; Liaisons with contract contacts and other external/internal customers with responsibilities including: facilitating meetings, attending committee meetings, and addressing questions and concerns raised by contractor.
• Collaborates with the customer to design and adapt processes and deliverables to meet changing needs.
• Works with subcontractor(s) to develop and implement policies and procedures consistent with requirements of the prime contract.
• Provides updates and oral presentations regarding contract activity as requires by contract.
• Encourages staff and management to improve procedures in an effort to maximize production of deliverables including implementing training programs to provide continued learning for staff development.
• Ensures availability and training of resources. Provides job specific orientation and training when called upon. Works with the manager or others, develops training content, resources and programs specific to job functions. Documents records of training that includes: scheduling, registration and attendance, quality control of training products and evaluation summaries.
• Based on contract requirement, may develop a working relationship with the law enforcement partners to provide them the necessary support.
• Based on contract requirement, may provide oversight of, and provides customer service functions related to, the state agency, people receiving services, families of people receiving services, providers, and other stakeholders.

Supervisory Responsibilities

• Is responsible for the overall direction, coordination, and evaluation of their unit/s. Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems. May manage subordinate supervisors who supervise staff in the operational area. May also directly supervise non-supervisory employees.

To perform the job successfully, an individual should demonstrate the following competencies:

• Analytical - Synthesizes complex or diverse information; Collects and researches data; Uses intuition and experience to complement data; Designs work flows and procedures.
• Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions.
• Project Management - Develops project plans; Coordinates projects; Communicates changes and progress; Completes projects on time and budget; Manages project team activities.
• Change Management - Develops workable implementation plans; Communicates changes effectively; Builds commitment and overcomes resistance; Prepares and supports those affected by change; Monitors transition and evaluates results
• Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
• Managing People - Includes staff in planning, decision-making, facilitating and process improvement; Takes responsibility for subordinates' activities; Makes self available to staff; Provides regular performance feedback; Develops subordinates' skills and encourages growth; Solicits and applies customer feedback (internal and external); Fosters quality focus in others; Improves processes, products and services.; Continually works to improve supervisory skills.
• Quality Management - Looks for ways to improve and promote quality; Demonstrates accuracy and thoroughness.
• Business Acumen - Understands business implications of decisions.
• Judgment - Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process; Makes timely decisions.
• Planning/Organizing - Sets goals and objectives aligned with strategic objectives; communicates this vision; Develops realistic action plans and workable implementation plans; and monitors progress.
• Delegation - Delegates work assignments; Matches the responsibility to the person; Gives authority to work independently; Sets expectations and monitors delegated activities.
• Organizational - Organizes resources and manages competing priorities to achieve competing priorities with ability to track multiple projects through time. Takes mitigating steps when required and plans for additional resources.
• Communication Skills - Ability to communicate effectively in written and verbal formats to a wide variety of parties internal and external to the organization. Ability to present and facilitate large and small groups. Communicates in a timely manner.

Education and/or Experience:

• Bachelor's Degree and at least four years of related experience; or equivalent combination of education and experience.
• Juris Doctor with current/active law license (in any state) preferred
• A minimum of six years of related experience in Medicaid program integrity, including Medicaid appeals preferred

Computer Skills:

• To perform this job successfully, an individual should have knowledge of Project Management software and other basic office software.

Other Skills and Abilities:

• Collaboration and conflict resolution - works with multiple constituencies to ensure they have a voice, while working towards unifying goals. Communicates changes effectively; Builds commitment and overcomes resistance; Prepares and supports those affected by change; Monitors transition and evaluates results.
• Displays superior management skills and has demonstrated the ability to plan, implement, and monitor contractual requirements.
• Ability to interpret financial reports, monitor budgetary allocations and allocate resources to meet change contract needs.

Qlarant is an Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities.