Director, Business Services (Medicaid Operations)

Before you apply

Job source

Himalayas

Applying on

jobs.lever.co

Workplace

Fully remote

US state

Nationwide remote

Category

Administrative

Link last checked

Not checked yet

Posted

2 days ago

Closes

11/15/2026

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About the role

We are seeking a Director, Business Services for Medicaid Operations, to lead a critical area of our Revenue Management Services organization. In this role, you will serve as our Medicaid leader and subject matter expert, shaping how we deliver exceptional service, advance operational excellence, and bring industry-leading practices to our clients. You will play a highly visible leadership role—building strong partnerships across clients and internal teams, developing high-performing talent, and driving innovation, efficiency, and continuous improvement across the function. We continue to expand our services and solutions to help clients meet their strategic priorities, strengthen compliance programs, and optimize their Medicaid rebate management operations. This is an exciting opportunity for a leader who thrives at the intersection of client impact, team leadership, and business transformation. This role is fully remote. Responsibilities: Service Delivery & Operational Excellence Own and develop best-in-class delivery processes and outputs that provide clients with a positive experience and demonstrate the value of the service. Act as a driver of efficiency and a leader of change, continually improving business services processes and programs and championing best practices across the group. Direct the review and approval of Medicaid rebate deliverables to clients, ensuring quality, accuracy, compliance with government and contractual requirements, and adherence to SLAs. Responsible for review and approval of the setup and maintenance of customer contracts and data management within Model N systems. Comply with all SOC controls and internal processes and procedures. Medicaid Subject Matter Expertise & Regulatory Leadership Serve as the subject matter expert in Medicaid processing and contracting, setting best practices and sharing thought leadership with clients, direct reports, peer groups, and senior leadership. Understand the impact of regulatory changes, proactively identify the process and system changes required to support them, and educate internal and external stakeholders on those impacts. Drive rebate savings through a deep understanding of Medicaid claims-level detail validations and by partnering with states to resolve disputes. Team Leadership & People Development Lead, coach, and develop a high-performing Medicaid operations team, fostering a culture of accountability, collaboration, continuous improvement, and client service excellence. Build team capability through clear goals, ongoing feedback, development planning, and effective performance management that supports both individual growth and business priorities. Create an inclusive, globally connected team environment that enables colleagues across regions, functions, and time zones to work effectively together and deliver consistent results. Provide leadership through change, helping the team adapt to evolving client needs, regulatory requirements, technologies, and operational priorities. Client Relationship Management Own and grow strategic client relationships, serving as the senior point of escalation and developing strong partnerships with clients and internal stakeholders. Respond to customer and client inquiries regarding processing status, reconciliation questions, data discrepancies, and payment status. Cross-Functional Partnership & Innovation Collaborate with GP Pricing and GTN teams, participating in cross-functional meetings and providing insights and information as required. Work directly with product teams to drive system enhancements and efficiency, including adoption of AI and automation, ensuring requirements are defined and tested and that change management is in place to embed new capabilities into business processes. Qualifications: Bachelor’s degree in accounting, Finance, Business, or related field 10+ years of experience working in the pharmaceutical industry with Medicaid agreements, including experience leading teams and managing c

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