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Manager of Virtual Health – Champaign IL 61821

 

Position Summary:
The Virtual Health Program Manager, reporting to the Director of Virtual Health, will assist in executing the virtual health roadmap for delivering local, regional, statewide and national virtual health services that achieve Carle Health strategic objectives as well as needs of our members and patients. The manager is be responsible for all aspects of executing virtual health projects (to include education materials & training) and managing the portfolio of projects; managing regional clients and their satisfaction of Carle Health virtual health program services; participating in the evaluation of new technology; assisting with project prioritization; and managing virtual health program specialist(s). In collaboration with their Director, scale the program in order to meet the growing demands of the organization. Understands clinical workflows in inpatient, outpatient, post-acute, regional and home-based environments, as well as technology innovations. Supports change management efforts to transform virtual healthcare for members, patients and families. Represents virtual health strategy to internal and external stakeholders, translating how virtual health can improve clinical and cost outcomes and member/patient and clinician experience.

Qualifications:

EDUCATIONAL REQUIREMENTS

Bachelor’s Degree in Related Field. Master’s Degree preferred.


CERTIFICATION & LICENSURE REQUIREMENTS
None, clinical licensure preferred.


EXPERIENCE REQUIREMENTS
A minimum of two to three (2-3) years of virtual health professional experience working in health care or technology sectors. Experience in a clinical setting as a direct patient care provider preferred. Experience with project management and associated tools and processes as well as experience being independently accountable for successfully meeting performance, leadership and project goals is preferred.


OTHER REQUIREMENTS
Ability to partner with operational, clinical, regional outreach and payer teams to effectively and efficiently deliver virtual health solutions; Recruit, lead, coach, and inspire direct reports. Dynamic, versatile and capable of exploring new concepts and impactful innovations; customer focus servant leader and first class problem solver. Ability to lead projects from concepts to completion; Exceptional written and oral communication and relationship building skills.

Essential Functions:

  • Assist in development and execution of the virtual health strategic road map and achievement of organizational goals/objectives.   
  • Effectively manage virtual health projects through its overall life cycle.   
  • Manages virtual health equipment and vendor performance.  Make recommendations for changes when indicated.  
  • Adapt and redirect the road map to meet evolving consumer needs and expectations, market needs, and market demand. 
  • Work with leaders and clinical teams to develop use cases for new technology and virtual health solutions. 
    Regularly reviews program performance and member/patient feedback to ensure clinical outcomes and patient/member satisfaction and are optimized. 
  • Work with service lines and clinical departments to define clinical processes, policies and procedures for each use case. 
  • Provides education and training support to clinicians, support staff and patients. 
  • Effectively manage the program portfolio and key performance metrics of program success.  
  • Evaluate relevant technology solutions, introduce vetted technologies, and implement these technologies elevating clinical outcomes and financial metrics.
  • Develop strong business relationships with different stakeholders and be a change agent.  
  • Remains well-versed in reimbursement policies of Medicare, Medicaid and private payors, as well as federal, state and local laws pertaining to Virtual Health. 

Clipped from: https://careers.peopleclick.com/careerscp/client_Carle/external/gateway/viewFromLink.html?jobPostId=17867&localeCode=en-us

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Director, Value Based Programs at Bon Secours Mercy Health

 

Thank you for considering a career at Bon Secours Mercy Health!

DIRECTOR, VALUE BASED PROGRAMS | Work From Home/Remote

The position of Director, Value Based Programs will support the development and execution of BSMH value-based program strategy. The candidate will establish working relationships with managed care payers for assigned programs and efficiently balance demands of multiple accounts to ensuring timeliness, contract compliance and performance results. He or she will facilitate strategic growth discussions with payer and internal stakeholders to identify new payer partnerships, program opportunities and progression along the risk continuum. He or she will be the subject matter expert for program requirements, educating key stakeholders, providing guidance and recommendations during contract negotiations, identifying program issues / opportunities and evaluating program results.The director will be assigned a specific book of business to lead in all aspects.

Essential Functions

  • Advise Senior Leaders on emerging trends and methodologies for managed care value-based programs, CMS models of payment and Medicaid programs
  • Collaborates with analytical resources to quantify the impact of alternative proposals for new and renewing programs and program audits. Facilitating the reconsideration process as applicable.
  • Collaborates with leadership teams in the planning, assessment, design and implementation phases for value-based programs.
  • Deliver education and training on assigned value-based programs requirements and contractual terms to key stakeholders
  • Develops, assesses, and makes recommendations on program participation, improvements and renewals.
  • Facilitate oversight meetings with the Payer to monitor and discuss contract performance
  • Consult with key stakeholders to ensure program aligns with operational and clinical capabilities. Providing guidance on contract and program interpretations and requirements.
  • Manage ongoing relationship and performance of value-based contracts, including identifying opportunities for performance improvement, review of reporting, validation of adherence to contractual terms, and facilitate resolution of issues.
  • Negotiate value-based program terms and contract language for acute, ambulatory and Clinical Integrated Network as assigned in conjunction with Finance and Managed Care as applicable ensuring terms are in alignment with BSMH contracting priorities and objectives.
  • Support the development of managed care and governmental payer strategies and initiatives to adapt to ongoing healthcare payment reforms and evolving payment methodologies, including ACOs and value-based care initiatives
  • Supports governance and management meetings to include facilitation, planning and coordinating and follow-up

REQUIRED:

– Bachelors Degree in Business, Healthcare Management, Accounting, Finance or Related Field.

– Minimum of five years’ healthcare management experience involving complex delivery systems and organizations

– Effective negotiation and communication skills, plus the ability to utilize and interpret financial models and internal analyses. Knowledge of Managed Care, Finance, alternative payment methodologies, claim billing (CPT, HCPCS, ICD-10, DRG, etc. Self-starter, and proven ability to work well in a matrixed environment. Demonstrated project management skills with a successful track record. Proficiency with MS Office applications and web-based technologies. Excellent interpersonal communication with the ability to influence at all levels of the organization. Demonstrated ability to handle highly sensitive and confidential information in compliance with Health Insurance Portability and Accountability Act (HIPAA), and company confidentiality policies and procedures.

PREFERRED:

– Graduate Degree in Business, Healthcare Management, Accounting, Finance or Related Field.

– Experience evaluating, developing and/or negotiating value-based contracts Strong relationship building and influencing skills. Willingness to travel approximately 25% for face to face meetings. Excellent time management and prioritization skills. Highly collaborative team approach to work. Strong problem-solving skills, including the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action

Bon Secours Mercy Healthis an equal opportunity employer.

We’ll also reward your hard work with:

  • Comprehensive, affordable medical, dental and vision plans
  • Prescription drug coverage
  • Flexible spending accounts
  • Life insurance w/AD&D
  • An employer-matched 403(b) for those who qualify
  • Paid time off
  • Educational Assistance
  • And much more

Scheduled Weekly Hours:

40

Work Shift:

Days

Department:

SS Revenue Management – Revenue Management

All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you’d like to view a copy of the affirmative action plan or policy statement for Mercy Health – Youngstown, Ohio or Bon Secours – Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employers, please email recruitment@mercy.com. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at recruitment@mercy.com.

Clipped from: https://careers.bsmhealth.org/job/-/-/28933/3092659952

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Deputy Chief Operating Officer – New York, NY (MetroPlus Health Plan)

 
 

 

OUR MISSION We provide a caring, high-quality customer experience to preserve and improve the health and lives of New Yorkers with our integrated healthcare system. OUR VISION To be the number one plan of choice for the communities we serve.

Our Values

• Give care and compassion to all • Be customer powered: Align daily actions to positive, impactful customer experiences, connect with internal and external customers • Be proud of what we do: Take ownership and accountability, be solutions driven • Act as a team: Build trust, empower others, champion transparent communication • Thrive with change: Spark and support innovation, transform our business through technology and data

Culture

Our culture is one committed to quality, because quality allows us to collectively impact lives. OUR WORKFORCE IS OUR MOST VALUABLE ASSET We have built a culture that develops employees professionally and personally. Employees enjoy a familial atmosphere, with open door access to all levels within the organization, and a supportive management team that appreciates the value that each unique individual contributes to the company. Our philosophy is to promote teamwork, collaboration and cooperation throughout our organization, and we are committed to recognize and advance our staff based on their capabilities and performance.

Diversity

WE ARE AS DIVERSE AS THE POPULATIONS WE SERVE. The diversity and culture conversation within our company is a reflection of the same breadth of diversity throughout New York City and the members that we serve. We seek talented, creative individuals from a variety of backgrounds, worldviews and life circumstances to work with us. Developing and retaining our diverse staff is what brings better insights, better decisions, better service and innovation.

Benefits

Generous Time Off Paid vacation, Paid sick leave (so you can take care of yourself and eligible family members when needed most), and a package of up to 11 paid holidays Comprehensive Medical Coverage Plans including MetroPlus Gold, a no cost, no deductible commercial plan exclusively for those employed by New York City Dental and Vision Insurance Plan Employee Assistance Program Financial and savings benefits: 529 college savings plan, Flexible spending account programs, NYC Municipal Credit Union savings program, Employees qualify for Public Interest Loan Forgiveness, Licensure reimbursement, Transit benefit programs, Direct deposit Retirement and pension plans: NYC Employees’ Retirement System (NYCERS) Pension Plan, NYC Deferred Compensation Plan (DCP), 401 (k) and 457 plan, Health + Hospitals Tax Deferred Annuity (TDA) Program 403(b) plan, New York State Voluntary Defined Contribution Program (VDC), Financial wellness programs EMPLOYEE DISCOUNT OFFERS: Our staff members can access discounts for a variety of products, services, and entertainment, including: • Apple and Dell products • Cell phones and mobile plans • Gym memberships • Special discount pricing on sporting events, Broadway plays, concerts, movie tickets, travel packages, and other offers through Barclays Center, Plum Benefits, Perks@Work and Working Advantage ADDITIONAL BENEFITS *These benefits include some or all of the following options: -Disability Insurance -Life Insurance -Health Club Reimbursement -Supplemental Hospital Coverage -Tuition Reimbursement

Professional Development

We support professional development and growth, and the opportunity for all our staff to reach their highest levels of personal potential and team success. GET THE TRAINING YOU NEED TO ADVANCE Take advantage of various training opportunities in classroom and online settings Refresh or learn new technical or leadership skills Apply for full or partial graduate degree scholarships through the Mayor’s Graduate Scholarship Program

Why Join Us?

Because, we are woven into the fabric of New York City Joining our team means contributing to a New York City legacy of quality, affordability, innovation, and service that spans three decades Because, we care about you as a person Here, you’re truly part of the MetroPlus family. We treat our people the way we expect our people to treat our customers Because, we care about your growth We invest in our employees by providing them with extensive professional development opportunities, thus, enabling them to further their professional growth and achieve what they aspire to achieve Because, we care about your health and well-being That’s why we offer an excellent benefits package to every member of our team Because, we do work with real purpose We represent your values

Clipped from: https://www.indeed.com/viewjob?jk=1dd4193aa6ca82d9&tk=1eplnrhbpu4d3800&from=serp&vjs=3

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Eligibility Program Manager – Indianapolis, IN

 
 

Automated Health Systems, a dynamic and entrepreneurial healthcare company, is hiring a motivated and experienced management professional.

As the Eligibility
Program Manager, you will be responsible for leading Eligibility Agent Services in multiple counties in Indiana.

Qualifications for the position include:

  • Minimum 5 to 7 years’ direct management experience with maternal and child health programs required.
  • Previous enrollment and eligibility experience strongly preferred.
  • Strong technical proficiency to learn new software programs.
  • Ability to analyze data to balance workloads across offices.
  • Must possess knowledge of Medicaid or IN health care programs (i.e., Hoosier Works).
  • Bachelor’s Degree in related field or equivalent training/experience required.
  • Some travel required.

In addition to comprehensive and ongoing training, we offer full-time employees a suite of benefits, including health insurance, and dental and vision insurances.

 

 
 

Clipped from: https://www.indeed.com/viewjob?jk=a5e799ac86c79718&tk=1eplnstcsu3mj800&from=serp&vjs=3

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Manager of Capture Planning – Medicaid Strategy & Planning – Fully Remote – Indianapolis, IN – Indeed.com

Manager of Capture Planning – Medicaid – Remote Position

Available: November 2020

The Manager of Capture Planning will join a terrific employer and focus on securing bids and developing Medicaid business in states across the US. This position will oversee a staff of 2, lead development and execution of capture plans for RFPs, manage the process of pursuing a bid, and develop a winning plan. Candidates should This position is a permanently remote opportunity!

 
 

Job details

Salary

$110,000 – $140,000 a year

Job Type

Full-time

Number of hires for this role

1

Qualifications

  •  

 
 

  • Bachelor’s (Preferred)
  • Business Development: 5 years (Preferred)

Manager of Capture Planning – Medicaid – Responsibilities

  • In collaboration with the Market President or Market Development Director/Manager, the Vice President, Market Entry, and other senior level decision makers, defines the strategic direction for procuring (i.e. capturing) new and existing business.

 
 

  • Direct internal resources in order to: identify customer issues, find priorities and hot buttons; stage gate evaluation of the opportunity; development of opportunity strategy and win themes; identification, analysis, development, documentation, and approval of solutions; capture risk assessment and management; acquisition of data and other proof points to support a strong proposal.

 
 

  • Guides analysts and consultants on research of customer priorities, national trends, and solution alternatives

 
 

  • Establishes and leads cross functional work streams to arrive at informed strategic and tactical decisions, develop the capture planning deliverables, and execute the capture plan.

 
 

  • Contributes to process improvement efforts to improve efficiency, effectiveness, and quality of capture deliverables.

Manager of Capture Planning – Medicaid
– Requirements

  • Bachelors degree in Business Management, Healthcare Admin
  • Masters degree preferred
  • 5+ years of experience in management consulting, managed care, public health industry, or health insurance
  • Medicaid experience is highly preferred

Compensation will range to $140,000 + 15% bonus and 25 days PTO

Job Type: Full-time

Pay: $110,000.00 – $140,000.00 per year

Benefits:

  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Disability insurance
  • Flexible schedule
  • Health insurance
  • Life insurance
  • Paid time off
  • Vision insurance

Schedule:

  • Monday to Friday

Supplemental Pay:

  • Bonus pay

Education:

  • Bachelor’s (Preferred)

Experience:

  • Market Strategy: 5 years (Preferred)
  • Business Development: 5 years (Preferred)
  • Medicaid: 1 year (Preferred)
  • Market Intelligence: 1 year (Preferred)
  • Capture Planning: 1 year (Preferred)
  • RFP: 1 year (Preferred)

Work Location:

  • Fully Remote

 
 

Clipped from: https://www.indeed.com/viewjob?cmp=firstPRO-Inc.&t=Manager+Capture+Planning&jk=ba95f0ac8c590dcb&sjdu=QwrRXKrqZ3CNX5W-O9jEvYm9ZmF3VsESfMscwVfGfu2OhkHVhYCT7jH5dgEH0k4I196uMobKJgGTjJaY1dl3yk85Mq8pXdJVCs-8cT6S9QOsYN8F_5_jlUYzEVERnxggMdC73E95dbxQ0TN8qtasLw&tk=1eplnstcsu3mj800&adid=225327490&ad=-6NYlbfkN0CUiNPx3JJMftrniD84mdXKaxJ3iSjJgJAqzFniN-7X5qfIIbgtbL2t4OMTou7BWJfZpB9bHsw7jwCkZWx4jCHgzV36J8UiY5ebqBTocT9S7cUGiYSc-zI929VialFe-FPMmWakBhGbg4V7yrHH-LkGbegF4guGlifV2ngIYGBvSt8yBBdhfOpFPXf-3NMaEwgEaTLJ6p3PRxUKftG329l07myz5ahidDkl_-67kFj5BuYgcONiULZ27fCFBpAUYPm59wnyHvakZR3_zkMSjTuYVuPPJIZnidVe-m0SJnV1sJpB7sVL5ET_hBAPjYAQ8YMVqtZf_CsQc_sEpzrAItem&pub=4a1b367933fd867b19b072952f68dceb&vjs=3

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Indiana Medicaid CFO – Relocation Available – Indianapolis, IN – Indianapolis, IN 46262

This position is accountable for the day-day development and management of financial models and performance as it relates to business goals and objectives. This position will work with key leaders to ensure that the business is operating effectively, with sound financial analysis, and with appropriate financial and operating controls in place.

 
 

Primary Responsibilities:

  • Provide monthly financial reporting of key business initiatives
  • Provide ongoing financial analysis of development and operational results against the budget
  • Work side-by side with the Business Team and/or Finance personnel within OptumHealth and/or across other aspects of UnitedHealth Group, to fully understand the business and support the financial goals and objectives
  • Develop and implement controls to support these goals/objectives as needed
  • Provide analysis and support for developing ideas, programs and projects
  • Develop systems for key financial and operating initiatives, as needed, as business growth occurs and matures
  • Directly supervise key financial operating personnel as required; effectively support and promote the development of staff as required
  • The Indiana Market CFO will generate forecasts and analyze trends in sales, SG&A, provider performance, product line profitability, membership, medical costs, premium yields, and other areas of the business
  • The presents monthly, quarterly, annual operating results with findings and recommendations to internal stakeholders; and prepares health plan budgets and related analysis in conjunction with centralized support areas
  • Member of the health plan’s senior leadership team
  • Establishes and cultivates a strong relationship with the financial leaders in the state
  • Provides comprehensive balanced advice on finance policies
  • Frequently interacts with senior leaders, inside and outside the organization, to influence those leaders to adopt new ideas, products, and/or approaches
  • Manages and thoroughly monitors strategic projects that have an impact inside and outside of finance
  • Entrepreneurial approach to developing innovative solutions to meet customer/business needs
  • Provides leadership to and is accountable for the performance and direction through multiple layers of management and senior level professional staff; work most often impacts a large business unit, or multiple markets/sites
  • Develops and executes strategies that span a large business unit
  • Directs others to resolve business problems that affect multiple functions or disciplines
  • Product, service or process decisions are most likely to impact multiple functions and/or customer accounts (internal or external)
  • Contributes to the development of business strategy

 
 

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

  • Undergraduate degree in Finance, Accounting or equivalent field
  • 8+ years of broad experience in multiple Finance disciplines
  • Advanced knowledge of Health Care industry (2+ years minimum of Healthcare finance experience)
  • Experience reporting to Executive Leadership in a strategic partnership capacity
  • Ability to complete complex projects influence change in complicated, fast paced, matrix environment
  • Strong working knowledge of financial systems, statements and reports
  • Demonstrated success partnering with, leading and influencing multiple teams responsible for complex operations
  • 3+ years of managerial and leadership experience of a broad spectrum of professional finance staff (e.g. accounting, medical analysis, financial analysis, budgeting, actuarial, underwriting, etc.)
  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders

 
 

Preferred Qualifications:

  • MBA or CPA
  • Medicaid and/or Medicare experience

Clipped from: https://www.indeed.com/viewjob?jk=22cae2437f8171c2&tk=1eplnstcsu3mj800&from=serp&vjs=3

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Senior Medicaid Datawarehouse Analytics SME – Indianapolis, IN 46204

 
 

Senior Medicaid Datawarehouse Analytics SME

Are you a Medicaid Management Information System (MMIS) subject matter expert with technical/functional Medicaid Data Analytics experience? Do you want to help us transform the Medicaid market as it embraces modularization and we help our clients create a new future for Medicaid technology?

Work you’ll do

Provide expertise on Medicaid and Healthcare Analytics

Lead and manage project teams for both onshore and offshore efforts, manage and lead client facing discussions

Implement data warehouse for a States Medicaid agencies

Design, analyze, support and develop data warehouse objects, data quality processes, design and develop fact and dimension tables, logical and physical database design, data modeling, reporting objects and ETL processes.

Liaison with technical Subject Matter Experts (SMEs) on functional requirements, issues, and decisions

Work on project financials and engagement ergonomics

Perform Data analysis and profiling

Interpret the rules for data integration and conversion

Drive client conversations around technical and functional design and specifications.

Work in Cloud based environment (AWS or Azure )

Implement technology-enabled business solutions for clients as part of a high-talent team.

The team

Our Health Technology team implements repeatable solutions to solve our government clients’ most critical health technology related issues. We advise on, design, implement and deploy solutions focused on government health agencies “heart of the business” issues including claims management, electronic health records, health information exchanges, health analytics and health case management.

Our clients seek a fresh perspective on how to leverage reusable, interoperable and flexible solutions that will enable them to reduce costs, improve health outcomes and respond to public health crises. Professionals will use their deep health, government and technology consulting experience to strategically help solve our client’s technology challenges.

Qualifications

Required:

8+ years of experience.

Bachelor’s degree

MMIS experience

Desired:

Experience within Medicaid Management Information systems (MMIS), Medicaid or Commercial Health Care claims, Provider Management and/or Eligibility data

Experience implementing a data warehouse for State Medicaid Agency

Experience with one of more of the following: SQL/PLSQL, ETL, Cognos, R, Python, Tableau, QlikView, Power BI, Business Objects

Experience in designing, analyzing, supporting and developing data warehouse objects, data quality processes, fact and dimension tables, logical and physical database design, data modeling, reporting process metadata and ETL processes.

Experience working in Cloud based environment (AWS or Azure)

Healthcare Data Analytics

Oral and written communication skills, including presentation skills (MS Visio, MS PowerPoint

PMI Certification

Ability to travel

Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future

How you’ll grow

At Deloitte, our professional development plan focuses on helping people at every level of their career to identify and use their strengths to do their best work every day. From entry-level employees to senior leaders, we believe there’s always room to learn. We offer opportunities to help sharpen skills in addition to hands-on experience in the global, fast-changing business world. From on-the-job learning experiences to formal development programs at Deloitte University, our professionals have a variety of opportunities to continue to grow throughout their career. Explore Deloitte University, The Leadership Center.

 
 

Benefits

At Deloitte, we know that great people make a great organization. We value our people and offer employees a broad range of benefits. Learn more about what working at Deloitte can mean for you.

Deloitte’s culture

Our positive and supportive culture encourages our people to do their best work every day. We celebrate individuals by recognizing their uniqueness and offering them the flexibility to make daily choices that can help them to be healthy, centered, confident, and aware. We offer well-being programs and are continuously looking for new ways to maintain a culture where our people excel and lead healthy, happy lives. Learn more about Life at Deloitte.

 
 

Corporate citizenship

Deloitte is led by a purpose: to make an impact that matters. This purpose defines who we are and extends to relationships with our clients, our people and our communities. We believe that business has the power to inspire and transform. We focus on education, giving, skill-based volunteerism, and leadership to help drive positive social impact in our communities. Learn more about Deloitte’s impact on the world.

 
 

Recruiter tips

We want job seekers exploring opportunities at Deloitte to feel prepared and confident. To help you with your interview, we suggest that you do your research: know some background about the organization and the business area you’re applying to. Check out recruiting tips from Deloitte professionals.

 
 

Apply

Clipped from: https://www.indeed.com/viewjob?jk=db6bcee5baf5330b&tk=1eplnstcsu3mj800&from=serp&vjs=3

 
 

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Vice President, Population Health – Oklahoma City, OK –

Oversee and direct all population health functions for the assigned business unit based on, and in support of the company’s strategic plan.

  • Lead complex projects including affordability analyses around medical and pharmacy expense, business analysis, documentation of business requirements, and defining current/future scope of work.
  • Create and manage clinical affordability projects with internal partners, including but not limited to pharmacy, other clinical and network affordability teams, and pilots.
  • Create innovative solutions and process enhancements to drive financial and quality success.
  • Lead Clinical Model development and process support for the program in all approved state regions to align with the Clinical Model and meet the requirements for the program by supporting reports , technology and core team.
  • Identify trends between Consumer Assessment of Healthcare Providers and Systems (CAHPS) and Member Engagement; create programs/pilots to improve engagement with strategic partners.
  • Establish the organizations focus and direction regarding models of care that incorporate needs of all lines of business, focusing on quality and operational efficiencies across the organization.
  • Create and measure business and clinical outcomes with respect to the provision of clinical support for practice transformation and successful transition of practice to shared savings/risk contract.

Apply

Clipped from: https://www.indeed.com/viewjob?jk=a6bc5c527e6dd58a&tk=1eplo1k6qu3u4801&from=serp&vjs=3

Education/Experience:

Medical Doctor or Master’s degree in Nursing, Therapy, Pharmacy, Public Health/Administration or related field. MBA preferred. 8+ years of clinical experience in the Healthcare industry. Broad understanding of HEDIS and how it is used to drive business growth and efficiencies. Ability to develop, execute and improve clinical programs across large or multiple business units. Ability to identify, create and tracking clinical program opportunities for population health management. Prior experience in an innovation field, long term project, or evidence of driving successful clinical practice innovative solutions.


Licenses/Certification: Unrestricted license as MD, DO, PA, PT, OT, ST, RpH or PN in NC.


For WellCare of North Carolina Health plan: Individual responsible for providing oversight and leadership of all prevention/population health, care management and care coordination programs, including Local Care management plan, AMH model and care management delivered by Local Health Departments. Must reside in North Carolina; More than 5 years of demonstrated care management/population health experience in a large healthcare corporation serving Medicaid beneficiaries; NC licensed clinician (e.g. LCSW, RN, MD, DO).


Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Posted on

VP, Legislative & Government Affairs – Oklahoma City, OK

Serve as a liaison to state government entities to improve the legislative and regulatory environment for the state health plan and Centene Corporation

  • Assist with the development of state legislative public policy concerning state insurance, Managed Care Organization and Medicare and Medicaid regulations through the initiatives of state legislators and their staff

  • Develop strategic relationships with state legislative policymakers to enhance the health plan and Centene’s role as a partner with the state and to assist in shaping public policy initiatives

  • Identify, evaluate and analyze the impact of state legislative and regulatory issues for state health plan and Centene Corporation and advise management concerning their impact

  • Represent and serve as point person for the state health plan and Centene Corporation to outside trade groups/stakeholders including state AHIP organization, state medical association, state hospital association and related Medicare and Medicaid business vendors
  • Represent state health plan and Centene Corporation to state legislators and their staffs

  • Develop and shape legislative policies and strategies through relevant coalitions and issue advocacy campaigns

  • Balance reporting requirements to multiple constituencies including; Centene Corporation regional vice president, state health plan president, chief operating officers and Corporate regulatory and government affairs staff

Clipped from: https://www.indeed.com/viewjob?jk=617fc81fd8835019&tk=1eplo1k6qu3u4801&from=serp&vjs=3

Position Purpose:
Education/Experience:

Bachelor’s degree in Public Policy, Government Affairs, Business Administration or equivalent experience. Master’s or Law degree preferred. 5+ years of related experience. Extensive knowledge of state legislative and regulatory processes. Experience with state legislature, health care trade associations including America’s Health Insurance Plans (AHIP), National Association of Insurance Commissioners (NAIC) and federal and state Medicare and Medicaid laws and regulations. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.


Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law..