Regional Vp, Operations Jobs

R-306553
Description
Responsibilities
The LTSS Program Manager (aka RVP, Operations/ COO) is dedicated full-time to the Indiana Pathways Program. The LTSS Program Manager (aka RVP, Operations/ COO) oversees day-to-day operations of the Indiana Pathways program, implementing strategic plans and fostering key relationships with stakeholders. They promote intradepartmental coordination, data and trend analysis, and quality improvements, establishing long range goals, objectives, and plans that evolve along with the needs of members, providers, and FSSA. They also monitor financial and operational performance, ensuring adherence to contract requirements and performance goals.
Responsibilities

• Leads conflict resolutions to maintain positive relationships with members, providers, FSSA, subcontractors, and other stakeholders
• Owns execution of daily operating objectives and goals, including key performance metrics
• Liaises between FSSA, plan leadership, and corporate leadership responsible for the execution of contract deliverables
• Directs and coordinates day-to-day plan functions, including reporting, claims administration, encounter data quality, grievances and appeals, member services, provider services, and business continuity planning and emergency coordination
• Understands and actively manages ongoing adherence to local, state, and federal regulatory and programmatic requirements
• Leads internal infrastructure to review and improve operational functions
• Plans organizational growth and potential staff successions
• Mitigates risks potentially impacting the state of Indiana and the plan by proactively monitoring any risk factors and red flags that may arise during operations
• Oversees development and maintenance of operational policies and procedures
• Works with the President to maintain important stakeholder relationships throughout Indiana
• Effectively implements business plans and oversees audit processes
• Communicates with FSSA and direct plan/corporate leadership regarding any necessary operational or regulatory changes
• Develops and cultivates a diverse and inclusive environment
• Manages implementation of strategic plans developed in cooperation with the President
• Maintains intimate familiarity with contractual requirements and stipulations

Required Qualifications

• 3 or more years of Leadership experience in a management role
• Must be able to travel in-state and willingness to commute to Indianapolis, IN on a weekly basis for leadership and state meetings
• Bachelor’s degree in Business, Operations Management, Healthcare Administration, or related field
• Minimum 5 years of prior experience in administering managed long-term care programs OR Equivalent experience in administering long-term services and supports programs, including HCBS (Home and Community Based Services), or Manage Care Health plan operations
• Candidate will reside in the state of Indiana or willing to relocate there within 3 – 6 months of hire.
• Experience leading departmental activities to ensure accurate and timely accounting, financial and statistical reports

Preferred Qualifications

• Experience in strategic and thought leadership in supporting Medicaid health plans
• Master’s degree in Business, Operations Management, Healthcare Administration, or related field

Additional Information

• The state calls this role LTSS Program Manager at Humana the role is leveled as a Regional VP, Operations
• This position reports directly to the President, Humana Healthy Horizons in Indiana

Scheduled Weekly Hours
40