Regional VP Operations IL Medicaid

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Job Information

Humana

Regional VP, Operations IL Medicaid

in

Chicago

Illinois

Description

Humana's Illinois Medicaid, Operations Officer (COO) will be responsible for the strategic development and oversight of operations for Humana's Illinois Medicaid plan. This role requires an in-depth understanding of how organization capabilities interrelate across segments and/or enterprise-wide. He/she will manage ongoing operations across multiple levels of the organization to meet operational contract requirements and financial performance goals. The Leader will be directly accountable for operational results.

Responsibilities

The COO works with various groups such as IT, Claims, Risk Management, Quality, Network, Member & Provider Services, Clinical, Analytics and Community Engagement, and Providers/Hospitals/Ancillary externally.  Drives optimization thru strategic planning and addressing specific business performance issues across matrixed organization and fostering key relationships with business stakeholders. Decisions are typically related to intradepartmental coordination, development and implementation of strategic plans, and business outcomes, and develops and implements strategic plans for the scope of management that are aligned with the Segment or Business strategy.

Key Responsibilities

Liaise between the Illinois Department of Medicaid Services, plan leadership, and corporate contacts responsible for the execution of contract deliverables

Work with the plan CEO to maintain important stakeholder relationships throughout Illinois

Lead the operational team supporting Nursing Facility and Nursing Facility Eligible populations

Lead internal infrastructure execution and oversight strategy ensuring continuous improvement of functions

Manage implementation of strategic plans developed in cooperation with the plan CEO

Oversee development and maintenance of operational policies and procedures

Effectively implement business plans and oversee audit processes

Own execution of daily operating objectives and goals, including key performance metrics

Plan organizational growth and potential staff successions

Develop and cultivate a diverse and inclusive environment

Maintain intimate familiarity with contractual requirements and stipulations

Understand and actively manage ongoing adherence to local, state, and federal regulatory and programmatic requirements

Communicate with Illinois Healthcare and Family Services and direct plan/corporate leadership regarding any necessary operational changes

Lead conflict resolution for any provider relations or network issues that may occur

Implement and ensure compliance with corrective action plans if necessary

Required Qualifications

8 years of experience working in healthcare operations and/or health plan management

Leadership background with more than five (5) direct-reports

Prior experience developing methods and criteria for measuring and summarizing data for complex analyses

Ability to lead and manage special projects that may necessitate cross-functional partnerships

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

4 years of experience in Medicaid MCO plan operational leadership; experience in strategic and thought leadership in supporting Medicaid health plans

Must reside or relocate to IL (within 3 months of employment)

Preferred Qualifications

Bachelor's degree in Business, Operations Management, Healthcare Administration, or related field

Additional Information

Location: Must reside in IL. Preference Chicago or suburb.

Work Style: Hybrid/Office; average 3 days in office

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Scheduled Weekly Hours

40

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.

Company info

Humana Inc.
Website : http://www.humana.com