Health Plan President, Magellan Complete Care of Virginia

Glen Allen VA 23060 Suite 100

Job Description

Has profit and loss responsibility, oversight, maintenance and growth for the Health Plan businesses. Serves as the main point of contact for key Medicaid contracts in government entities where applicable. Responsible for building and managing the relationship between the Health Plan and individual state representatives on all Medicaid products and services as it relates to both acquisition and retention of Medicaid contracts.

Essential Functions

  • Manages financial performance, operating budget and variances from plan to ensure cost effective delivery of service. Responsible for development and implementation of annual operating budget.  
  • Oversees compliance for all operations performance standards, develops and activates action plans to bring back to compliance when standards are not met.
  • Responsible for developing and fulfilling service level agreement with Account Management.
  • Ensures that operations and clinical staff provide appropriate and efficient services.  
  • Continually monitors services and programs to ensure that client needs and contract obligations are being met in accordance with policies and procedures.
  • Directs the delivery of high-quality services within the sites and ensures that quality management plans and protocols are implemented and that services are delivered in accordance with policies and procedures. Monitors quality assurance indicators and provides quality oversight.
  • Manages high-risk cases and utilization trends.  Provides required management reports to internal and external customers and clients.
  • Assists with the coordination of network provider activities.  
  • Directs administrative and infrastructure operations activities such as lease negotiations, staffing plans, supervision of non-clinical staff, telephone systems, etc. Oversees all area clinical and operations staff with respect to recruitment, hiring, promotion and dismissal; ensures adequate training and orientation of new staff and ongoing professional development of existing staff.  Ensures adherence to human resources policies and procedures.

General Job Information

Title

Health Plan President, Magellan Complete Care of Virginia

Grade

36

Job Family

Operations Group

Country

United States of America

FLSA Status

United States of America (Exempt)

Recruiting Start Date

3/13/2019

Date Requisition Created

3/13/2019

Minimum Qualifications

Education

Bachelors: Healthcare (Required), Masters

License and Certifications - Required

License and Certifications - Preferred

Other Job Requirements

Responsibilities

  • 10+ years experience in healthcare with a clinical and/or operations management focus. 8+ years management level experience in the managed healthcare industry required.
  • Thorough knowledge of managed healthcare principles and call center operations.
  • Understands financial and quantitative information and has ability to manage operations within budgets.
  • Ability to identify problems, recognize symptoms and causes.
  • Establish and implement solutions.
  • Ability to develop effective teams, resolve conflicts and build collaboration among all levels in the organization.
  • Achieve organizational goals through development of effective teams.
  • Motivate and empower others to attain personal and team goals.
  • Proven negotiation skills.

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