VP Operations, Health Plan

Richmond VA 23233

Job Description

Responsible for the strategic and tactical direction and oversight of the health plan’s operations and network strategy. This includes development of strategy, relationship management of key vendors, oversight of the community support delivery system and community engagement, and coordination of relationships with the state, members, and participating providers. Responsible for developing and implementing a network strategy that meets the customer requirements and assures access to a network of services that is within budget and cost of care plans. Provides leadership and management oversight to the plan in the absence to the market president. Maintains responsibility for ensuring the effective collaboration between centralized functions, vendor partners and key decision makers.
  • Oversees all health plan operations including provider relations, contracting, community outreach and engagement, information technology and reporting.
  • Develops service level agreements and manages centralized functions to agreements to ensure health plan contractual requirements are met.
  • Manages key vendor relationships, ensuring contract requirements are delivered upon.
  • Oversees system migrations, ensuring information technology requirements are translated into plans and budgets for implementation, production and operation.
  • Develops and implements a comprehensive network strategy that meets contractual requirements and assures access to a network of services that supports member access and cost of care plans.
  • Develops and implements a network strategy to assure long term mutually successful physician, practitioner/facility, and organization provider relationships.
  • Directs all provider (physician, practitioner, facility and organizations) recruitment activities.
  • Establishes programs to develop and maintain positive relationships between provider constituents and stakeholders, and influences and changes behavior of providers in accordance with business operations goals and objectives.
  • Directs cross-functional projects across the organization, driving improvement activities or developing and implementing innovative, value-added business processes, in alignment with the overall strategic direction of the health plan and goals of Magellan Complete Care.
  • Provides leadership, management, development and mentoring of staff in meeting objectives and performance expectations.

General Job Information

Title

VP Operations, Health Plan

Grade

33

Job Family

Operations Group

Country

United States of America

FLSA Status

United States of America (Exempt)

Recruiting Start Date

2/12/2020

Date Requisition Created

2/3/2020

Work Experience

Healthcare, Management/Leadership, Operations

Education

Bachelors: Business Administration (Required), Bachelors: Healthcare Administration (Required), Masters

License and Certifications - Required

License and Certifications - Preferred

Other Job Requirements

Responsibilities

  • Master's Degree
  • Bachelor's Degree in Business Administration or Healthcare Administration.
  • 10+ years of experience in healthcare with an operations and network management focus.
  • 10+ years of management level experience in the managed healthcare industry required, preferably in a matrix environment.
  • Knowledge of managed healthcare delivery systems to include critical components and interdependencies.
  • Knowledge of the variety of financial and operational structures viable in the managed care arena.
  • Ability to communicate and advocate at the consumer engagement level and up through corporate staff levels including the CEO.
  • Strong leadership and negotiation skills.
  • Motivate and empower others to attain personal and team goals.
  • Achieve organizational goals through the development of effective teams.

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.