Company name
Humana Inc.
Location
Chicago, IL, United States
Employment Type
Full-Time
Industry
Manager, Executive, Clevel, Operations, 100k
Posted on
May 30, 2023
Profile
Job Information
Humana
Regional VP, Operations IL Medicaid
in
Chicago
Illinois
Description
Humana's Illinois Medicaid, Operations Officer (COO) will be responsible for the strategic development and oversight of operations for Humana's Illinois Medicaid plan. This role requires an in-depth understanding of how organization capabilities interrelate across segments and/or enterprise-wide. He/she will manage ongoing operations across multiple levels of the organization to meet operational contract requirements and financial performance goals. The Leader will be directly accountable for operational results.
Responsibilities
The COO works with various groups such as IT, Claims, Risk Management, Quality, Network, Member & Provider Services, Clinical, Analytics and Community Engagement, and Providers/Hospitals/Ancillary externally. Drives optimization thru strategic planning and addressing specific business performance issues across matrixed organization and fostering key relationships with business stakeholders. Decisions are typically related to intradepartmental coordination, development and implementation of strategic plans, and business outcomes, and develops and implements strategic plans for the scope of management that are aligned with the Segment or Business strategy.
Key Responsibilities
Liaise between the Illinois Department of Medicaid Services, plan leadership, and corporate contacts responsible for the execution of contract deliverables
Work with the plan CEO to maintain important stakeholder relationships throughout Illinois
Lead the operational team supporting Nursing Facility and Nursing Facility Eligible populations
Lead internal infrastructure execution and oversight strategy ensuring continuous improvement of functions
Manage implementation of strategic plans developed in cooperation with the plan CEO
Oversee development and maintenance of operational policies and procedures
Effectively implement business plans and oversee audit processes
Own execution of daily operating objectives and goals, including key performance metrics
Plan organizational growth and potential staff successions
Develop and cultivate a diverse and inclusive environment
Maintain intimate familiarity with contractual requirements and stipulations
Understand and actively manage ongoing adherence to local, state, and federal regulatory and programmatic requirements
Communicate with Illinois Healthcare and Family Services and direct plan/corporate leadership regarding any necessary operational changes
Lead conflict resolution for any provider relations or network issues that may occur
Implement and ensure compliance with corrective action plans if necessary
Required Qualifications
8 years of experience working in healthcare operations and/or health plan management
Leadership background with more than five (5) direct-reports
Prior experience developing methods and criteria for measuring and summarizing data for complex analyses
Ability to lead and manage special projects that may necessitate cross-functional partnerships
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
4 years of experience in Medicaid MCO plan operational leadership; experience in strategic and thought leadership in supporting Medicaid health plans
Must reside or relocate to IL (within 3 months of employment)
Preferred Qualifications
Bachelor's degree in Business, Operations Management, Healthcare Administration, or related field
Additional Information
Location: Must reside in IL. Preference Chicago or suburb.
Work Style: Hybrid/Office; average 3 days in office
#LI-SJ1
Scheduled Weekly Hours
40
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.
Company info
Humana Inc.
Website : http://www.humana.com