The Jurisdiction Program Director shall be responsible for the oversight of the contract requirements as well as the overall operations in the jurisdiction. In addition, the Jurisdiction Program Director shall oversee the coordination of activities to ensure the following:

· Act as the primary point-of-contact for all jurisdictions/contractual issues & questions, as identified and/or raised by CMS

· Staffing is appropriate;

· Effective lines of communication with internal staff and external stakeholders;

· Contract requirements are met including quality, cost control, timeliness and business relations;

· Ensure an adequate Quality Assurance (QA) program and process are in place and strictly adhered to for all tasks;

· Monthly cost reports are submitted timely and accurately, including a plan to correct any cost variances or projected rate adjustments;

· Timely and quality submission of deliverables and ad hoc requests; and

· Maintain superior business relations with CMS, LE, MACs and all other stakeholders and partners.

Additional Responsibilities:

Responsible for establishing the strategic direction of a major sector of the business. Provides oversight and coordination of activities of the business unit. Works with senior management and group leaders to establish business plans, identify and respond to new business and ensure the ongoing effective performance of all contracts in the unit.

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

· Oversees a significant section of the business.

· Work with group of leaders to monitor and ensure that all customer requirements are met.

· Works through others or provides direct leadership and oversight for the group’s fiscal performance, oversees and manages budgets.

· Develops and utilizes measurement systems to evaluate contract performance and improvement, assists teams in developing and implementing improvement strategies.

· Representative at State and National level in relation to contract administration.

· Assists in the development and monitoring of corporate policies.

· Oversees the implementation of new contracts and responds to RFP process.

· Report to and collaborate with interested parties to investigate and resolve compliance issues.

· Works with senior management to establish annual goals for the business unit and direct the efforts of the group to ensure their achievement.

· Considerable opportunity to interpret procedures and instructions, and to choose among alternate courses of action. Work allows considerable opportunity to organize own and others’ tasks, decide priorities and influence the overall efficiency of the work unit.

· Protects and maintains the privacy of associate personnel records, including compensation information.

Supervisory Responsibilities

May manage subordinate supervisors who supervise employees and/or directly supervise non-supervisory employees. 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.

Required Skills

Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations.

Managing/Leading 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; Fosters quality focus in others; Improves processes, products and services. Serves as a mentor to leaders and managers.

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 - 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; Improves processes, products and services.

Quality Management - Looks for ways to improve and promote quality; Demonstrates accuracy and thoroughness.

Business Acumen - Understands business implications of decisions; Displays orientation to profitability; Demonstrates knowledge of market and competition; Aligns work with strategic goals.

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 - Prioritizes and plans work activities; Plans for additional resources; Sets goals and objectives; Develops realistic action plans.

Communication Skills – Ability to communicate effectively in written and verbal formats to a wide variety of parties internal and external to the organization including technical reports.

Delegation - Delegates work assignments; Matches the responsibility to the person; Gives authority to work independently; Sets expectations and monitors delegated activities.

Organizational Support - Follows policies and procedures; Completes administrative tasks correctly and on time; Supports the organization's goals and values; Benefits organization through outside activities.

Required Experience

Work Experience

Ten or more years of professional experience, with at least eight years in health care, Medicare, Medicaid, or a related private insurance field and a minimum of three years in a progressive management capacity with responsibility for managing complex systems and workflows.

Educational Requirements

A master’s degree from an accredited institution or a bachelor’s degree from an accredited institution plus an additional five years of related professional experience.

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

Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations.

Managing/Leading 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; Fosters quality focus in others; Improves processes, products and services. Serves as a mentor to leaders and managers.

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 - 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; Improves processes, products and services.

Quality Management - Looks for ways to improve and promote quality; Demonstrates accuracy and thoroughness.

Business Acumen - Understands business implications of decisions; Displays orientation to profitability; Demonstrates knowledge of market and competition; Aligns work with strategic goals.

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 - Prioritizes and plans work activities; Plans for additional resources; Sets goals and objectives; Develops realistic action plans.

Communication Skills – Ability to communicate effectively in written and verbal formats to a wide variety of parties internal and external to the organization including technical reports.

Delegation - Delegates work assignments; Matches the responsibility to the person; Gives authority to work independently; Sets expectations and monitors delegated activities.

Organizational Support - Follows policies and procedures; Completes administrative tasks correctly and on time; Supports the organization's goals and values; Benefits organization through outside activities.