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Director, Market Operations - Little Rock, United States - CareSource
Description
Job Summary:
The Senior Director, Market Operations is responsible for planning, organizing, and leading market initiatives and the implementations of CareSource, client, program, and State initiatives.
The Senior Director, Market Operations is responsible for working directly with Enterprise Operations and the Market Lead to prepare the market for growth and continued operations.
Essential Functions:
Ensure successful execution and completion of market initiatives that drives operational improvements
Partner with Enterprise Operations, Claims, Configuration managers and leaders
Leads Market growth/product additions and implementations including tracking and executing on operational/contractual initiatives necessary for successful implementation and ongoing operations (i.e. Marketplace, DSNP, Medicaid population additions)
Manages all vendors assigned to support the Market both Internal and External, including collaborating with Enterprise to establish and maintain regular Joint Operating Commitees and SLA/Contractual performance
Establishes Operations organizational budgets and collaborates with other market leads including Care Management, Compliance, Network/Provider Relations and monitors for adherence in conjunction with Executive Leadership,
Collaborates with Market and Enterprise Finance to monitor member and provider utilization and propose, build and implement QAI Initiatives
Leads large scale transformational change in the market, working effectively with all levels of the organization, individual and team, across disciplines and geography
Works collaboratively with Market Operations and Enterprise IT and Data Analytics to identify operational and functional gaps, developing processes and timelines for updates and implementation as needed
Ensures contractual requirements/updates are tracked and executed to meet Quality, Compliance and Operational requirements
Creates the framework for advance troubleshooting and root cause resolution of operational issues specific to the products supported
Evaluates operational process effectiveness for accomplishing market goals and objectives; manage operational process improvement activities
Incorporates industry standard, best practice project management tools and techniques in market initiatives
Develops and implements new or improved processes and procedures for operational effectiveness and efficiencies in collaboration with market teams
Recognizes and proactively manages operational dependencies and risks across market operations initiatives portfolio through effective change and risk management controls
Works closely with leadership to establish, communicate, and perpetuate the corporate vision, ensuring appropriate communication to stakeholders
Ensures portfolio-level operational readiness through ongoing communications to senior management, stakeholders, and sponsors
Interacts heavily within business partner group, and business integration, and enterprise services
Builds strong working relationships with all departments within Operations
Builds strong working relationships with Clinical, IT, Quality, and Regulatory, and any other area in which collaboration will be essential for driving within CareSource to drive process improvements and adherence
Perform any other job duties as requested
Education and Experience:
Bachelor's Degree in a related field or equivalent years of relevant work experience is required
Minimum of seven (7) years of business management or health care operations experience in insurance, managed care, or related industry equivalent healthcare environment is required
Minimum of five (5) years of leadership and management is required
Project management experience preferred
Knowledge and experience in Medicaid, CHIP, and other health and human services programs
Overall knowledge and understanding of Operations-related systems, technical specifications and processes is preferred
Competencies, Knowledge and Skills:
Able to effectively identify business problems, assess proposed solutions, and understand the needs of business partners and stakeholders
Demonstrated consistent Market and Enterprise level understanding of operations
Ability to communicate effectively with executive and senior leadership
Develops effective working relationships with business partners and stakeholders
Demonstrated knowledge working directly with Enterprise contacts with experience managing implementation and resolving claims, configuration, and other operational functions in a matrixed environment
Ability to successfully initiate and manage multiple operational initiatives
Can easily conform to shifting priorities, demands, and timelines
Intermediate proficiency level with Microsoft Office suite, including Microsoft Project and Visio is preferred
Strong leadership skills
Excellent oral and written communication and interaction skills
Possesses excellent relationship management skills that will build and maintain strong working relationships
Licensure and Certification:
Project Management Certification is preferred
To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position.
CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October - March 31) as a condition of continued employment.
Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified.
CareSource adheres to all federal, state, and local regulations.CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position.
Request for accommodations will be completed through an interactive review process.Working Conditions:
General office environment; may be required to sit or stand for extended periods of time
May be required to travel, estimated at less than 10%
Compensation Range:
$130, $228,100.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type:
Salary
Competencies:
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