[Hiring] Vice President, Market Operations @CareSource

Role Description

Vice President, Market Operations - Ohio is responsible for developing the overall market program strategy and business objectives; lead the alignment and collaboration to establish CareSource as the industry leader in member and provider engagement, member and provider experience, and plan management in the market.

• Develop the overall market program strategy and business objectives.
• Responsible for oversight of more than five products (e.g.; ABD – A, ABD – K, Magi, AFK, expansion, MSY – FFS, CFC, Marketplace, DSN, and Duals) within the market to ensure profitability, compliance, and growth.
• Lead and collaborate with the Market leadership team to establish strategic and operational goals for the Market.
• Manage over 500k members across the market.
• Identify additional growth strategies and product diversification.
• Establish key relationships with partners and stakeholders associated with market and product expansion opportunities.
• Translate business/program vision and strategy into operational tactics and build necessary organizational support and infrastructure.
• Lead program implementation in new markets, allocate implementation team resources, and facilitate ongoing operations.
• Establish post-implementation strategy and goals to mitigate program risks.
• Oversee day-to-day program operations for market, including establishing and overseeing controls to ensure requirements are in place.
• Lead regular market business reviews with various stakeholder groups (including, but not limited to, human resources, information technology, finance, Business Partner Group, quality improvement, and Care4U).
• Develop, translate, and execute key strategies or functional/operational requirements for market.
• Facilitate leadership team in the establishment of organizational goals and priorities.
• Ensure market operations achieves its short- and long-term strategic priorities with maximum effectiveness and efficiency.
• Oversee allocation of staffing resources and responsibilities for market operations.
• Initiate and oversee operational plans and initiatives to create cross-functional capabilities across key functional areas.
• Collaborate with corporate compliance to escalate key issues and work to resolve them.
• Develop and maintain in-depth knowledge of the company’s regulatory environment.
• Assist in transforming regulatory procedures into policies, plan changes, reporting, or other operational outcomes.
• Collaborate with Finance and Data Management to develop internal reporting for ongoing management and external reporting for compliance.
• Oversee departmental finances/budget and ensure sales forecast/budget are met.
• Perform any other job duties as requested.

Qualifications

• Bachelor of Science degree in finance, business, or health care field or equivalent work experience is required.
• Master’s degree is preferred.
• Five (5) years of health plan operations experience is required.
• Five (5) years of leading division and corporate initiatives to drive systemic change and consumer adoption of health insurance and engagement initiatives is required.
• Five years of management experience in managed care setting is required.

Requirements

• Intermediate proficiency level with Microsoft Office.
• Knowledge of full range of product requirements from regulatory, operations, clinical, reporting, and compliance.
• Critical listening and systematic thinking skills.
• Ability to attract, manage, and develop team members; Inspirational Leadership.
• Ability to maintain confidentiality and act in the company’s best interest.
• Oral, written, and interpersonal communication skills.
• Leadership experience and skills.
• Energetic, enthusiastic, and politically astute.
• Ability to act with diplomacy and sensitivity to cultural diversity.
• Responsive to a changing environment.
• Health Plan Financial & Administration Management Acumen.
• Strategic management skills.
• Conflict resolution skills.
• Planning, problem identification, and resolution skills.

Benefits

• Compensation range $150,000-$300,000.
• Consideration of a combination of a candidate’s education, training, and experience.
• Potential for a bonus tied to company and individual performance.
• Comprehensive total rewards package.

Licensure and Certification

• Influenza vaccination is a requirement of this position.
• Annual proof of Influenza vaccination for designated positions during Influenza season (October 1 – March 31) is required.
• Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination.
• CareSource adheres to all federal, state, and local regulations.
• Reasonable accommodations to qualified individuals with disabilities or medical conditions are provided.

Working Conditions

• General office environment; may be required to sit or stand for extended periods of time.
• Ability to travel as required by the needs of the business.

Company Description

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.