POSITION SUMMARY/RESPONSIBILITIES

Responsible for the strategic performance of the Community First Third-Party Administrator (TPA) Services, Inc., organization, ensuring strong alignment with Community First's mission and long-term diversification strategy. Builds collaborative relationships with other department leaders, to ensure the success of the TPA's administrative service portfolio, including claims administration, provider network management, enrollment and eligibility services, regulatory reporting, and member services, positioning the TPA Services organization as a trusted high-performing partner with contracted clients.

EDUCATION/EXPERIENCE

A bachelor's degree is required. A minimum of 10 years of progressively responsible relevant experience will be accepted in lieu of educational requirements. The ideal candidate will possess a minimum of 8 years of progressively responsible leadership experience in health plan operations, third-party administration, managed care, or a related healthcare services environment, along with demonstrated success in building or managing a TPA Services organization, health plan operations department, or similar administrative services function. Experience with Texas Department of Insurance (TDI) regulations and TPA Services licensing is highly desirable, as is a proven record of driving financial performance through revenue growth, operational efficiency, and margin management. Experience in an HMO or managed care setting is required.