Director II – Medicaid State Operation

Elevance Health

Director II Medicaid State Ops overseeing operations in Tennessee at Elevance Health. Leading strategic initiatives and ensuring quality services across health plan operations.

Posted 6/19/2026full-timeNashville • Ohio, Tennessee, Virginia, Wisconsin • 🇺🇸 United StatesLead💰 $148,480 - $256,128 per yearWebsite

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

health plan operationsMedicaid programsMedicare programsclaims payment processesencounter submission requirementsLTSSdual eligible populationscomplex care management programsTennessee Medicaidregulatory requirements

Soft Skills

leadershipcollaborationstrategic planningrisk managementcommunicationcommunity relationsnetwork developmentoperational executioncross-functional team leadershipperson-centered care management

Certifications & Qualifications

BA/BSMaster’s degree

Industry Keywords

HMOhealthcareMedicaid managed carestate agenciesregulatorsbusiness initiativestransformation effortscomplianceoperational functionsstrategic priorities

About the role

Key responsibilities & impact

Develops, directs, plans, and evaluates the goals and objectives for Wellpoint Tennessee
Leads day-to-day health plan operations
Ensures effective execution of strategic priorities and contractual requirements
Collaborates with the Plan President to establish overall standards, policies, and objectives
Ensures alignment and support with overall Medicaid Business Unit mission
Identifies operational risks and implements mitigation strategies
Partners with clinical leadership for person-centered care management solutions
Partners with RVP of provider networks for network operations strategy
Leads implementation of major business initiatives and transformation efforts
Responsible for local marketing, community relations, network development, and compliance

Requirements

What you’ll need

Requires a BA/BS in a related field
Minimum of 8 years relevant experience
In-depth experience in the HMO/healthcare field
Minimum of 5 years working with Medicaid and/or Medicare programs
Master’s degree preferred
Demonstrated experience leading large-scale operational functions and cross-functional teams strongly preferred
Strong knowledge of Medicaid managed care programs and regulatory requirements strongly preferred
Strong understanding of claims payment processes and encounter submission requirements
Experience working directly with state agencies and regulators strongly preferred
Experience with LTSS, dual eligible populations, and complex care management programs strongly preferred
Knowledge of Tennessee Medicaid (TennCare) programs and regulations strongly preferred

Benefits

Comp & perks

comprehensive benefits package
incentive and recognition programs
equity stock purchase
401k contribution
paid holidays
Paid Time Off
medical
dental
vision
short and long term disability benefits
wellness programs
financial education resources