Director, Health Partner Engagement

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $113k - $197.7k / year

⏰ Full Time

🔴 Lead

👔 Director

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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CareSource

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 30+ years

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

CareSource is a health services company focused on providing affordable health insurance and healthcare solutions. It offers a wide range of plans including Medicaid, Marketplace, and Medicare Advantage, targeting low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Additionally, CareSource provides members with resources for COVID-19 support, dental, vision, and hearing benefits, as well as pharmacy services. The company emphasizes easy access to healthcare management through online platforms and a mobile app.

📋 Description

• Direct, oversee, and manage relationships with key Health Partners throughout the state • Identify and foster communications with Health Partners to reduce high-cost utilization trends and meet contract financial targets • Evaluate policy and process changes, monitor implementation of initiatives, and provide leadership on initiatives affecting Health Partners • Manage the Health Partner Relations team and drive Health Partner issues to completion • Engage Health Partner associations and partners to strengthen relationships and identify collaboration opportunities • Lead efforts to achieve Quality measures and withhold targets; educate Health Partners on HEDIS and CAHPS measures and facilitate data collection • Assist with development and execution of negotiation plans and lead or support negotiations with Contracting leadership • Lead Health Partner Relations staff and ensure effective daily activities supporting network strategy and financial targets • Execute process improvement strategies to improve inquiry response times, employee engagement, and Health Partner satisfaction • Ensure regulatory compliance, accreditation standards, and successful participation in market audits • Provide education, leadership, analysis, and support regarding Cost of Care, Value-Based Reimbursement, and cost-saving initiatives • Translate goals and objectives into practical integrated solutions and deliver financial value to Health Partners and CareSource • Develop and communicate performance improvement measurements and strategies • Ensure consistent Health Partner communications and portal messaging • Provide regional leadership to cross-functional teams to achieve market goals • Hire, manage, train, coach, and develop the Health Partner Relations team • Develop and manage the annual budget • Perform other job-related instructions as requested

🎯 Requirements

• Bachelor’s degree or equivalent years of relevant work experience is preferred • Master’s degree is preferred • Minimum of seven (7) years of health plan/managed care experience required • At least three (3) years of leadership experience preferred • Leadership experience and knowledge of managed care best practices • Experience driving strategic partnerships and operational improvements • Knowledge of Medicaid, Medicare, and Marketplace program managed care regulations • Strong verbal and written communication skills • Strong management, budgetary, and operations skills • Understanding of administrative, technical, and clinical dimensions of health care • Valid driver’s license, car, and insurance necessary for work-related travel • Successful clearance of a driver’s license record check • Annual Influenza vaccination required for designated positions during Influenza season • Ability to travel greater than 50% of the time • Ability to work in a general office environment and use general office equipment

🏖️ Benefits

• Bonus tied to company and individual performance may be available • Comprehensive total rewards package • Influenza vaccination requirement and vaccination record support • Reasonable accommodations for qualified individuals with disabilities, medical conditions, or sincerely held religious beliefs • Flexible hours, including possible evenings and/or weekends as needed • Equal opportunity and belonging-focused workplace