Integrated Care Program Operations Manager

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $94.1k - $164.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Program Manager

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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

• Assist the Duals team with open projects and progress toward completion • Support program enhancements, development, execution, implementation, and ongoing design and standardization for Dual eligible and LTSS models • Collaborate with markets to implement business strategies and operational plans supporting LTSS (HCBS and NH) models • Translate business and program vision and strategy into operational tactics and build organizational support and infrastructure • Support post-implementation strategy and goals to mitigate program risks • Evaluate operational process effectiveness and manage process improvement activities with market teams • Coordinate, translate, and execute key functional and operational requirements • Provide leadership and support for product expansion • Apply industry-standard project management tools and techniques to market initiatives • Manage operational dependencies and risks across the market operations initiatives portfolio through change and risk controls • Work with leadership to establish, communicate, and perpetuate the corporate vision • Monitor performance across markets' LTSSS/HCBS programs to leverage best practices and improve outcomes through evidence-based standardization • Assist the dual eligible President in monitoring legislative and governmental activities and identifying opportunities and issues • Interact with Dual Eligible and LTSS program business partners and build relationships across markets • Engage stakeholders to ensure alignment • Lead activities that deliver high-quality, consistent initiatives producing optimal outcomes for members, providers, and program goals • Perform other job-related duties as requested • Work in a general office environment and potentially sit or stand for extended periods • Travel up to 15% based on department needs

🎯 Requirements

• High School or GED required • Bachelor's degree preferred • Four (4) years of clinical operations/healthcare administration experience required • Four (4) years of experience driving performance and process improvements in the health care insurance industry required • Three (3) years of experience with government-regulated (Federal and/or State) health insurance products, including Medicaid, Managed Care Waiver, FFS and Medicare preferred • Three (3) years of experience implementing programs with focus on integration preferred • Three (3) years of project management experience preferred • Ability to identify business problems, assess proposed solutions, and understand business partner and stakeholder needs • Ability to communicate effectively with all levels of leadership • Strong organizational, time management, analysis, and problem-solving skills • Ability to manage a project from start to finish • Strong relationship-building skills and leadership qualities • Training and teaching skills/change agent capability • Ability to think critically and lead with strategy • Comprehensive knowledge of Clinical Operations, Market Groups, Business Development, Network, and Operations • Hands-on proficiency in Microsoft Office tools, including Project, Outlook, Word, PowerPoint, and Excel • Business acumen and politically astute ability to act with diplomacy and sensitivity to cultural diversity • No licensure or certification required

🏖️ Benefits

• Bonus tied to company and individual performance may be available • Substantial and comprehensive total rewards package • Equal Opportunity Employer environment focused on belonging and supporting individuals of all backgrounds