This position is responsible for directly overseeing all fiscal and administrative operations, including the areas of clinical operations, quality, compliance, network, regulatory, finance, human resources, customer service, claims payment and billing, information technology and reporting. Responsible for the overall management and performance of the service center, including development of policy and procedure, management of community support delivery system within budgetary goals, and coordination of relationships with the state, plan members and members in care, participating providers, partners and the community.
-Directly oversees all fiscal and administrative operations, including the areas of clinical operations, quality, compliance, network, regulatory, finance, human resources, customer service, claims payment and billing, information technology and reporting. Has authority to commit to expenditures within the authority delegated by leadership.
-Leads business operations which includes collaborating with and supporting the clinical and program staffs to ensure that operational supports (processes, systems, structures, resources) are in place, effective and efficient to deliver high quality services within budget, that system principles are supported with financial resources; and determining information technology requirements and overseeing plans and budgets for implementation, production and operation.
-Has responsibility and authority over all daily administrative and fiscal operations. This includes decision-making authority for controlling fiscal expenditures and ensuring that operations support system requirements.
-Oversees all areas of human resources with respect torecruitment, hiring, promotion and dismissal; ensures adequate training andorientationof new staff and ongoing professional development of existing staff. Ensures adherence to human resources policies and procedures.
Bachelors (Required), Masters
License and Certifications - Required
License and Certifications - Preferred
Other Job Requirements
10yearsexperience inhealthcare with a clinical and administrative operations management focus.4years management levelexperience in the managedhealthcare industryrequired., Knowledge of managedhealthcare delivery systems to include critical components and interdependencies. Knowledge of the variety offinancial and operational structures viable in the managed care arena. Knowledge of operational issues unique to the delivery of integrated care delivery, population management, strategic planning and thebudget process. Ability to communicate and advocate at the consumer engagement level and up through corporate staff levels including the CEO. Strong leadership skills. Must possess strong analytical and organizational skills in a multiple site and function environment. Proven ability to manage operations in a larger matrixedhealthcare system. Negotiating andcontracting skills. Exceptional team leadership and communication skills.