Sr. Director, Operations

Orlando FL 32819

Job Description

This position would be responsible for the overall management of a health plan, including oversight of clinical and administrative operations. This includes the areas of clinical, member retention, customer service, network, claims, information technology, reporting, vendor management and shared services oversight.
  • Ensures service delivery while implementing and transitioning to new process and technology strategies to reduce administrative cost structure.
  • Manages care spend.  Responsible for all cost of care strategies/initiatives.
  • Drives quality management initiatives and interfaces with corporate quality area.
  • Directs customer-specific, cross-functional projects in conjunction with various departments to develop and implement innovative, value-added solutions.
  • Provides oversight of health plan vendors in partnership with corporate resources.
  • Actively engages in business development process to expand our presence state, both within existing and in new, emerging markets. 
  • Provides oversight of operations functions, including mail, facilities, telecom, IT, member retention/experience, member& provider portal, and infrastructure for new program implementations in expansion markets to ensure successful program execution.
  • Provides oversight and serves as liaison with shared service operations, including claims, enrollment, encounters and contact centers. Monitors and reports on service level agreements.

General Job Information

Title

Sr. Director, Operations

Grade

31

Job Family

Operations Group

Country

United States of America

FLSA Status

United States of America (Exempt)

Recruiting Start Date

2/15/2019

Date Requisition Created

2/15/2019

Minimum Qualifications

Education

Bachelors (Required), Masters

License and Certifications - Required

License and Certifications - Preferred

Other Job Requirements

Responsibilities

  • Managed care knowledge of data systems, database management, provider networks, claims payment and/or clinical services.
  • Managed healthcare industry knowledge and demonstrated successful management of complex, interdependent functions.
  • Proven ability to plan, organize, schedule, direct, control, and monitor large-scale, multi-functional project activities.
  • Proven experience interacting with executive management and providing concise project reporting for board level review.
  • Ability to perform basic financial and quantitative analysis.
  • Well-developed interpersonal skills, as well as excellent verbal and written communication skills.
  • Knowledge of information systems, EDI, and e-health technologies.
  • Strong working knowledge of Microsoft Office Product Suite, including Visio.

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled