Executive Director of Health Plan Operations

1 week ago

Washington, United States MedStar Health Full time
Job Summary

The Vice President (VP) - Executive Director is a visionary leader responsible for the long-term success and sustainable growth of MedStar Family Choice - DC's health plan. This role requires a passionate advocate for health equity, coupled with strategic expertise in navigating the complexities of the Medicaid program and leading the organization through dynamic regulatory and healthcare environments.

Key Responsibilities
  1. Develop and implement department goals, objectives, policies, and procedures to ensure compliance with business unit policies and procedures, governmental and accreditation regulations.
  2. Oversee the financial health and sustainability of the Medicaid health plan, managing budgets, revenue projections, resource allocation, and ensuring fiscal responsibility and compliance with regulations.
  3. Lead a management team of direct reports and shared services staff, managing within a matrix environment, and ensuring quality, cost-effectiveness, and a positive member experience.
  4. Develop and contribute to the achievement of established goals and objectives, adhering to MedStar Health and MedStar Family Choice's strategic plans.
  5. Provide leadership and maintain operations and procedures to ensure MedStar Family Choice - DC is in compliance with its government contracts and adheres to all federal and Maryland state Medicaid regulations.
  6. Assist in the development of annual and long-range operating and capital budgets and forecasts for MedStar Family Choice.
  7. Collaborate with the President of MedStar Family Choice to develop, implement, and manage a strategic planning process that results in a vision for MedStar Family Choice - DC consistent with MedStar Health's strategic plan.
  8. Represent or designate representatives for MedStar Family Choice - DC at all meetings called by the Department of Healthcare Finance and other agencies.
  9. Prepare and present information concerning MedStar Family Choice - DC operational performance and strategies to the MedStar Family Choice board of directors.
Requirements
  • Bachelor's degree in Business Administration, Public Health, Health Administration, or related field required. Master's degree preferred.
  • 10+ years of progressively responsible experience in healthcare, delivery systems, or health plan in a senior role, ideally with a managed care organization; successful experience with more than one organization is preferred.
  • Minimum of five (5) years in a senior leadership role within a Medicaid organization required.
Preferred Qualifications
  • Proficient problem-solving, including being able to identify and resolve complex problems, such as developing innovative solutions based on extensive knowledge of managed care.
  • A broad understanding of information systems and programs and the strategic and operational values they bring to healthcare analytics and operations.
  • Excellent verbal and written communication skills.

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