Public Health CareerMart

Key Functions & Responsibilities:

• Work with the Plan leadership to set goals, clearly define operations, and develop appropriate performance standards, metrics and reporting tools.
• Set vision and lead operational departments by directing and coordinating activities consistent with established goals, compliance and quality requirements, objectives and policies and procedures.
• Develop short and long term strategies and tactics to assure operational and programmatic excellence, management and control.
• Oversee the integration of all reporting departments in order to maximize the effective use of all resources and expertise.
• Develop, implement and govern the information systems and technology infrastructure including day-to-day operations.
• Accountable for strategy, architecture, delivery and support of all IT applications and computing infrastructure for the Plan.
• Lead and direct the implementation of managed care information systems and monitor all applications to ensure they are effective, capable of rapid response, and meet organizational and operational needs.
• Direct and oversee the business application portfolio with a focus on current and future business objectives to ensure the Plan remains on state of the market technology to support staff and third party vendors.
• Initiate, implement and monitor IT process improvement activities aimed at reducing costs, improving quality and speed to market.
• Initiate, implement and monitor improvement activities aimed at reducing costs, increasing accuracy and efficiency and both internal and external customer satisfaction in each operational area.
• Develop and implement strategies to deliver superior Customer Service, Enrollment and Claims Administration to members and providers.
• Serve as the organization’s security officer.
• Develop and implement strategies to mentor, motivate and retain key employees.
• Responsible for chairing Business Continuity Planning (BCP)/Emergency Preparedness efforts within BMCHP. Responsible for coordinating inter-plan operations (IPO) meetings.
• Oversee diverse functional staff groups consisting of 120-200 employees in Operations and IT.
• Also responsible for Executive oversight of cross functional groups for major on-going strategic initiatives.

Education & Experience:

Required:

• Bachelor’s degree
• MBA, MPH or related post-graduate degree
• 10+ years of senior management experience, with a minimum of 5 years leading the Information Technology function and 5+ years leading one or more of the following functions: Customer Service, Claims, Enrollment, Quality Assurance or Provider Audit
• 10+ years of experience in a managed care/health care environment or a related government program
• Demonstrated experience successfully planning, organizing, managing and implementing Executive level projects
• Experience with Medicaid programs and their regulations, guidelines, and standards

Competencies, Skills, and Attributes:

• Proven leadership skills and ability to build effective teams
• Strong oral and written communication skills, ability to interact with all levels of the organization
• Results-oriented individual with the ability to build relationships and implement solutions
• Demonstrated change agent
• Proficient in the design and use of information systems and analytics to generate and drive data analyses that quantify and improve the quality and efficiency of care delivered by providers
• Proven negotiation skills, relationship building ability and knowledge of risk concepts
• Familiarity with software packages for health care organizations; experience with Facets and CCMS packages desired
• Expertise utilizing Microsoft Office products

Highly Proficient in the following Competencies:

• Getting work done through others
• Understanding the business
• Making complex decisions
• Inspiring others