Regional Vp, Operations Medicaid Ok

The Chief Operating Officer (COO) establishes long-range goals, objectives, and plans and monitors financial and operational performance. They will be responsible for the strategic development and oversight of operations for Humana’s Oklahoma Medicaid Plan. They will manage ongoing operations across multiple levels of the organization to meet operational Contract requirements and financial performance goals. They will be accountable for operational results. The COO represents the Plan externally and to State and external agencies.

Responsibilities

• Manages implementation of strategic plans developed in cooperation with the Plan leaders
• Understands and actively manages ongoing adherence to local, State, and federal regulatory and programmatic requirements
• Owns execution of daily operating objectives and goals, including key performance metrics
• Leads internal infrastructure to review and improve operational functions
• Oversees development and maintenance of operational policies and procedures
• Works with the plan Chief Executive Officer to maintain important stakeholder relationships throughout Oklahoma
• Mitigates risks potentially impacting the State of Oklahoma and the plan by proactively monitoring any risk factors and red flags that may arise during operations
• Develops and cultivates a diverse and inclusive environment
• Plans organizational growth and potential staff successions
• Leads conflict resolution for any Provider relations or network issues that may occur
• Effectively implements business plans and oversees audit processes
• Liaise among OHCA, plan leadership, and corporate contacts responsible for the execution of Contract deliverables
• Maintains intimate familiarity with Contractual requirements and stipulations
• Communicates with OHCA and direct plan/corporate leadership regarding any necessary operational or regulatory changes
• Directs and coordinates day-to-day plan functions, including Reporting, Claims Administration, Encounter Data Quality, Grievance and Appeals, Information Technology and Systems, Enrollee Services, Provider Services, and Business Continuity Planning and Emergency Coordination

Required Qualifications

• Leadership background with more than five (5) direct-reports
• Four (4) to six (6) years of experience working in healthcare operations
• Bachelor’s degree in Business, Operations Management, Healthcare Administration or related field
• Minimum two (2) years of experience in health plan management

Preferred Qualifications

• Experience in strategic and thought leadership in supporting Medicaid health plans
• Master’s degree

Additional Information

• This role is based in Oklahoma City
• Role is leveled as RVP, Operations

Scheduled Weekly Hours

40