VP, Market Operations – Preferred Experience in Managed Care, Ohio

Job not on LinkedIn

🔥 1 hour ago

🏈 Ohio – Remote

🏈 Ohio – Remote

💵 $150k - $300k / year

⏰ Full Time

🔴 Lead

⚙️ Operations

🦅 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

• Develop the overall Ohio market program strategy and business objectives • Lead alignment and collaboration to establish CareSource as an industry leader in member and provider engagement, experience, and plan management • Oversee more than five products within the market to ensure profitability, compliance, and growth • Lead the Market leadership team in establishing strategic and operational goals • Manage over 500,000 members across the market • Identify growth strategies and product diversification opportunities • Establish relationships with partners and stakeholders for market and product expansion • Translate business and program vision into operational tactics and organizational infrastructure • Lead program implementation in new markets, allocate resources, and facilitate ongoing operations • Establish post-implementation strategies and goals to mitigate program risks • Oversee day-to-day market program operations and operational controls • Lead regular market business reviews with stakeholder groups including HR, IT, Finance, quality improvement, and Care4U • Develop, translate, and execute market strategies and operational requirements • Facilitate organizational goals and priorities with the leadership team • Ensure short- and long-term strategic priorities are achieved effectively and efficiently • Oversee staffing resources and responsibilities for market operations • Initiate operational plans and cross-functional capabilities • Collaborate with Corporate Compliance to resolve issues, maintain contract compliance, and translate regulatory procedures into operational outcomes • Collaborate with Finance and Data Management on internal and external compliance reporting • Oversee departmental finances, budgets, and sales forecasts • Perform other duties as requested

🎯 Requirements

• Bachelor of Science degree in finance, business, or health care field or equivalent work experience is required • Master’s degree is preferred • Five (5) years of health plan operations experience is required • Five (5) years of leading division and corporate initiatives to drive systemic change and consumer adoption of health insurance and engagement initiatives is required • Five years of management experience in managed care setting is required • Intermediate proficiency with Microsoft Office • Knowledge of product requirements spanning regulatory, operations, clinical, reporting, and compliance • Health Plan Financial & Administration Management Acumen • Strategic management skills • Conflict resolution skills • Planning, problem identification, and resolution skills • Influenza vaccination is required as a condition of continued employment during Influenza season (October 1–March 31); employees hired during the season have 30 days to complete it • Ability to travel as required by business needs

🏖️ Benefits

• Bonus tied to company and individual performance • Comprehensive total rewards package • Influenza vaccination requirement and immunization support • Reasonable accommodations for qualified individuals with disabilities, medical conditions, or sincerely held religious beliefs • Ability to travel as required by business needs