Medicaid Strategic Operations Supervisor

Let’s do great things, together!

About Moda
Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together.

Job Summary:
The Strategic Operations Supervisor oversees the planning and execution of strategic Medicaid initiatives and innovations. This role manages escalated issues, monitors performance, identifies cost-saving opportunities, and leads fiscal and budgetary planning. The Supervisor ensures compliance with federal, state, and contractual requirements; identifies and mitigates operational risks; and supports the quality, efficiency, and integrity of Medicaid program operations.

This is a full-time hybrid position based in Portland, Oregon.

Pay Range
$64,394.27 - $80,498.01 (annually) depending on experience.
This role may be classified as hourly (non-exempt) depending on the applicant's location. Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range.

Please fill out an application on our company page, linked below, to be considered for this position.

Benefits :

• Medical, Dental, Vision, Pharmacy, Life, & Disability
• 401K- Matching
• FSA
• Employee Assistance Program
• PTO and Company Paid Holidays

Primary Functions:

1. Lead Medicaid cost-saving initiatives by analyzing, recommending, implementing, and tracking outcomes across internal departments and external entities.
2. Develop and maintain departmental and executive dashboards and performance metrics, including identifying measurable KPIs for key priorities and initiatives.
3. Articulate strategic visions and translate them into actionable initiatives, offering alternative pathways and solutions when needed.
4. Provide strategic support on projects and deliverables of varying complexity and across stakeholder groups, incorporating feedback and pivoting direction or proposals as needed.
5. Manage competing departmental priorities and coordinate data requests to ensure effective and timely execution.
6. Recommend and implement policies and operational changes that support cost savings, process improvements, and future expansion efforts.
7. Communicate data findings, insights, and strategic recommendations to department leadership, stakeholders, and executive teams.
8. Stay current on and interpret state and federal legislation impacting Medicaid dollars and operations.
9. Conduct local and national market research to identify opportunities for operational innovation.
10. Ensure regulatory compliance while enhancing infrastructure and minimizing operational risk.
11. Support third-party administrator (TPA) business accounts.
12. Travel frequently to Eastern Oregon and other regions across the state.
13. Perform other duties as assigned.

Required Skills & Experience:

1. Bachelor’s degree in Business Administration, Finance, or a related field, required; Master’s degree preferred.
2. Minimum of 4 years of experience in Oregon Medicaid, healthcare operations, or regulatory compliance, with strong knowledge of financial principles and cost management.
3. Proven ability to identify cost savings and implement operational improvements within healthcare systems.
4. Experience with claims pricing, contract configuration, negotiation, and management, including the ability to identify and propose alternative strategies during complex negotiations.
5. Strong project management, organizational, and analytical skills.
6. Proficiency in Microsoft Office, with the ability to create effective reports and dashboards.
7. Skilled in presenting data, proposals, and recommendations to executive leadership and diverse stakeholders.
8. Excellent written, verbal, and interpersonal communication skills for effective cross-functional collaboration.
9. Demonstrated situational awareness, emotional intelligence, and confident leadership in navigating complex or sensitive situations.
10. Track record of innovation, adaptability, and collaboration in dynamic environments.
11. High attention to detail, reliability, and consistent follow-through.
12. Professional appearance and demeanor in all internal and external interactions.
13. Must possess a valid driver’s license.

Contact with Others & Working Conditions:

• Office environment with extensive close PC and keyboard use, constant sitting, and frequent phone communication. Must be able to navigate multiple computer screens. A reliable, high-speed, hard-wired internet connection required to support remote or hybrid work. Must be comfortable being on camera for virtual training and meetings. Work in excess of standard workweek, including evenings and occasional weekends, to meet business need. Frequent travel.
• Internally with Medicaid Leadership, including the Board of Directors, Clinical Advisory Panel, and internal departments. Externally with various entities and stakeholders.

Together, we can be more. We can be better.

Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training.

For more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our ... email.