Administrative Operations Manager II/Compliance Bureau Chief (HCA/MAD #10110891)

$36.09 - $57.75 Hourly

$75,072 - $120,115 Annually

This position is a Pay Band 85

Posting Details

This posting will be used for ongoing recruitment and may close at any time. Applicant Lists may be screened more than once.

This job posting may be used to fill multiple vacancies.

Our Vision

• Every New Mexican has access to affordable health care coverage through a coordinated and seamless health care system.

Our Mission

• We ensure that New Mexicans attain their highest level of health by providing whole-person, cost-effective, accessible, and high-quality health care and safety-net services.

Our Goals

• Leverage purchasing power and partnerships to create innovative policies and models of comprehensive health care coverage that improve the health and well-being of New Mexicans and the workforce.
• Achieve health equity by addressing poverty, discrimination, and lack of resources, building a New Mexico where everyone thrives.
• Implement innovative technology and data-driven decision-making to provide unparalleled, convenient access to services and information.
• Build the best team in state government by supporting employees' continuous growth and wellness.

Why does the job exist?

The Compliance Bureau Chief will:

• Establish and monitor an effective compliance program for Medical Assistance Division (MAD);
• Implement all necessary actions to ensure achievement of the objectives for an effective compliance program, including compliance with all relevant federal and state regulations;
• Identify potential areas of non-compliance and associated risks as well as develop/implement corrective action plans to resolve problematic areas;
• Issue and report regularly to senior management on progress of compliance efforts;
• Coordinate with other staff throughout the agency as required to track and follow up as federal regulations are issued and/or updated;
• Review state compliance and other agency risks within the bureau.

How does it get done?

The Compliance Bureau Chief is responsible for:

• Ensuring the agency has an effective compliance program, including researching and understanding of new and existing applicable laws and related policies and procedures;
• Assessing internal controls, new federal regulatory guidance, compliance with existing laws and policies and executing a plan of action for implementation in collaboration with key management staff in the division;
• Overseeing individuals in the agency interfacing with audits, compliance and federal partners;
• Collaborating with other mangers and deputies as needed to organize project plans, action plans and implementation of timelines when new federal and state regulations are released;
• Assisting with activities and efforts related to Managed Care procurements and ensuring compliance with State Procurement code;
• Assisting with convening stakeholder groups as necessary;
• Effectively coaching employees and developing teamwork by building and maintaining positive working relationships with employees and division leadership;
• Providing timely and appropriate feedback to employees, delegating assignments to subordinates and ensuring clear understanding of performance expectations;
• Coordinating as needed with the Office of the Secretary (OOS) and other Medical Assistance Division (MAD) staff to comply with record requests, development and monitoring of HIPAA policies and other compliance activities of the Department;
• Effectively communicating and collaborating with internal/external individuals for the division to achieve desired goals, including MCO staff, other state agencies, advocacy groups, legislators, providers and contractors;
• Providing effective support for the development and implementation of Medicaid policy and identifying opportunities for improving procedures to implement regulatory compliance.

Who are the customers?

Internal and External stakeholders throughout Health Care Authority (HCA), MAD, CMS and Office of the Secretary for HCA;

Federal Partners can include, but are not limited to:

• Office of Inspector General (OIG)
• Centers for Medicare & Medicaid Services (CMS)
• Department of Health and Human Services (HHS)

Ideal Candidate

The Ideal Candidate has:

• Knowledge of and working experience with the Medicaid Program;
• Experience with Medicaid and/or health care programs;
• Experience developing and implementing government policies and procedures;
• Experience working with multiple stakeholders;
• Ability to prioritize many critical projects.

Minimum Qualification

A Bachelor's Degree in any field of study from an accredited college or university and eight (8) years of professional level experience with a light strategic impact directly related to the purpose of the position defined by the agency at the time of recruitment. Substitutions Apply. See Substitution Table below. A hiring agency will designate a portion of the required experience to include management, supervisory and/or specialized experience. Any required licensure, certification or registration shall be defined at the time of recruitment and will be in addition to the above requirements.

Substitution Table

These combinations of education and experience qualify you for the position:
Education Experience 1 High School Diploma or Equivalent AND 12 years of experience 2 Associate's degree AND 10 years of experience 3 Bachelor's degree AND 8 years of experience 4 Master's degree AND 6 years of experience 5 PhD degree AND 4 years of experience
• Education and years of experience must be related to the purpose of the position.

• If Minimum Qualification requires a specific number of "semester hours" in a field (e.g. 6 semester hours in Accounting), applicants MUST have those semester hours in order to meet the minimum qualifications. No substitutions apply for semester hours.

Employment Requirements

Must possess and maintain valid drivers license;

Must obtain a Defensive driver certification.

Working Conditions

Work is performed in an office setting with exposure to Visual/Video Display Terminal (VDT) and extensive personal computer and phone usage with extended periods of sitting. Must be able to lift 25lbs.

Supplemental Information

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Agency Contact Information: Jolene Jaffa (505) 690-9920 or jolene.jaffa@state.nm.us.
For information on Statutory Requirements for this position, click the Classification Description link on the job advertisement.

Bargaining Unit Position

This position is not covered by a collective bargaining agreement.