Director, Market Operations

5 - 7 years experience  •  Insurance

Salary depends on experience
Posted on 10/25/17
Fort Myers, FL
5 - 7 years experience
Salary depends on experience
Posted on 10/25/17

Position Description

The Director of Market Operations has management responsibility for day to day regional market operations. The position is responsible for facilitating the creation and execution of local market strategies and action plans. The position is involved in planning, budgeting, forecasting, facility planning and reporting for each of the assigned markets. This will include being a local liaison with health plan payors, building hospital relationships and overseeing network development, network management and local office management in assigned markets. This position may supervise multiple markets as directed.


This position has a dotted line matrix management responsibility for all other functional staff located within assigned markets - including marketing, utilization management, disease management and transportation. This position works cross functionally with all other divisions in the corporation including sales, medical management, finance, claims, customer and member services, IT and facilities to achieve market goals and objectives.  


The responsibilities of this position demand a wide range of capabilities including: strategic planning and analysis skills; strong accounting knowledge and understanding of financial statements; understanding of managed care contracts; management breadth to direct and motivate; highly developed communication skills; political savvy; and the ability to develop clear action plans and drive process, given often ambiguous issues with numerous interdependencies. Analyzes data from a variety of statistical and financialreports and develops recommendations, strategic plans and action plans to improve identified financial deficits.


This position will work closely with key payor and physician groups to develop long-term strategic relationships.


Primary Responsibilities:

  • Provides supervision for market personnel as assigned and participate on the management team directed by the Vice President of Market Operations

  • Participates in strategic and operational planning for the assigned market(s) and facilitate the execution of the plan within that assigned market

  • Works closely with Corporate Sales & Marketing to attain membership goals by identifying business opportunities, and retention of key physicians along with internal growth of their practices

  • Continually seeks ways to improve job efficiencies

  • Creates and executes a comprehensive market strategy developing an assessment of competitors and local market trends benefit design and a marketing plan as well as a network development plan

  • Facilitates the development and execution of the local market action plan for each market that the regional director is assigned

  • Provides cross functional leadership across the health plan by maintaining open communication, identifying, resolving cross functional issues, continually improving cross functional policies/procedures/work flows and support systems and proactively facilitating staff development to achieve the goals and objectives of each assigned market

  • Maintains effective network support services by working with the Vice President of Market Operations

  • Performs all other duties as assigned


Required Qualifications:

  • Bachelor’s degree in Business or Healthcare Administration or related field required (8 additional years of comparable work experience beyond the requiredyears of experience may be substituted in lieu of a bachelor’s degree)

  • 5+ years regional or senior-level managed care experience with an emphasis on network management, operations, financial analysis and employee supervision, provider contract negotiations and provider relations experience

  • Understanding of medical care delivery, network management and local market dynamics

  • Understanding of financial performance for the total market including staff budgeting and monitoring as well as the management and understanding of risk management with the risk groups

  • Solid management and supervisory skills (i.e. employee selection, training, coaching and development as well as process management)

Preferred Qualifications:

  • Master’s degree in Business, Healthcare Administration, or related field

  • Exceptional interpersonal skills with ability to interface effectively internally with all levels of staff and externally with a wide range of people including physicians, office staff, hospital executives, medical groups, IPA’s, the press and community organizations

  • Excellent problem solving skills with affective follow through

  • Strong verbal and written communication skills


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