Executive Director of Health Care Solutions

4 days ago

Lancaster, Pennsylvania, United States Penn Medicine Lancaster General Health Full time
Job Title: Executive Director Preferred Health Care

Job Summary:

Penn Medicine Lancaster General Health is seeking an experienced Executive Director to lead our Preferred Health Care team. As a key member of our leadership team, you will be responsible for developing and executing growth strategies to expand our group health TPA market share, revenue, and profitability, while maintaining high client satisfaction and retention.

Key Responsibilities:

  • Provide strategic direction and operational oversight, including P&L management, financial control systems, budgeting, forecasting, and reporting.
  • Develop and execute growth strategies to expand the group health TPA market share, revenue, and profitability.
  • Lead, coach, and develop a high-performing team of managers and staff, ensuring alignment with the company's vision, mission, values, and goals.
  • Establish and maintain strong relationships with key stakeholders, clients, prospects, partners, vendors, and industry associations, representing PHC as a thought leader and trusted advisor.
  • Knowledge of the principles and practices of health planning and management sufficient to manage, direct, and coordinate the operation of a managed care organization.
  • Knowledge of the purposes, organization, and policies of health systems sufficient to interact with other health care systems and providers.
  • Knowledge of the policies and procedures sufficient to direct full health plan and claims operations effectively.
  • Knowledge of the principles and practices of employee development sufficient enough to ensure organizational productivity, employee retention, and employee development.
  • Knowledge of stop loss insurance and insurance agency development, growth, and operations sufficient to develop, nurture, and grow in support of PHC's business plans.
  • Establishing and maintaining effective working relationships with employees, policy-making bodies, third-party payors, hospitals, and other health care organizations, patients, and the public.
  • Drive innovation and continuous improvement in all of the Company's solutions, leveraging technology, data, analytics, and best practices to enhance service delivery, quality, and efficiency.
  • Attends and provides management guidance to the Board of Directors, leading all planning and strategy development.
  • Ensure compliance with all applicable laws, regulations, policies, and standards.
  • Provides developmental leadership in the creation and operation of PHC's Third Party Administration, insurance agency, and stop loss marketplace programs in the support of Eliance Health Solutions and Penn Medicine.
  • Identifies and finalizes development of business relationships with third parties that are consistent with the overall business plans and objectives of PHC for Board approval.
  • Supports PHC's Quality Management Committee as needed and oversees administrative follow-up for problems and issues identified and led by the Medical Director.

Secondary Responsibilities:

  • Manages and oversees all leadership staff and their activities.
  • Approves all hires, reviews, promotions, and discipline for all staff.
  • Other duties as assigned.

Requirements:

  • Bachelor's degree in business, health administration, or related field.
  • Minimum 10 years of senior leadership experience in group health TPA, health insurance, or managed care industry, with proven track record of delivering results.
  • Strong business acumen, financial management, and analytical skills, with ability to develop and execute sound business strategies and plans.
  • Exceptional communication, presentation, and interpersonal skills, with ability to influence and collaborate with diverse stakeholders at all levels.
  • Demonstrated leadership, coaching, and team-building skills, with ability to inspire and motivate others.
  • Highly innovative, creative, and adaptable, with ability to embrace change and drive transformation.

Preferred Qualifications:

  • Master's degree preferred.

Cognitive Requirements:

  • Attention/Concentration: The position requires strong concentration skills.
  • New Learning and Memory: A large portion of this position requires reliance on verbal memory and new learning.
  • Problem Solving, Reasoning, and Creative Thinking: The position requires much autonomy of thought and problem-solving.

Attitudes:

  • Leadership, Control, and Planning: Ability to accept responsibility for leadership, direction, control, planning, negotiating, organizing, directing, supervising, formulating practices, or making final decisions.
  • Variety and Change: Ability to perform a variety of duties, often changing from one task to another of a different nature without loss of efficiency or composure.
  • Communication: Ability to exchange information with others clearly and concisely.
  • Interpersonal Relations: Ability to maintain relationships that facilitate task accomplishment.

Equipment Usage Requirements:

  • Computer, Phone, Copier, Printer, Fax, Office Supplies.
  • Microsoft Office Products, clinical information system.

Physical Requirements:

  • Sit: Frequently.
  • Stand: Occasionally.
  • Walk: Frequently.
  • Bend: Rarely.
  • Push: Rarely.
  • Pull: Rarely.
  • Kneel/Squat: Rarely.
  • Reach: Rarely.
  • Twist: Rarely.
  • Balance: Rarely.
  • Climb: Rarely.

Lifting: Degree of physical exertion is: Light.

Sensory Abilities:

  • Vision.
  • Hearing.

Physical Environment:

  • Working Conditions: Exposure to hazardous conditions/materials is negligible.

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