Senior Manager, MCO Plan Performance, HCI & Dual Programs
About The Position
The Illinois Department of Healthcare and Family Services (HFS), Bureau of Managed Care, is seeking a senior leader to oversee account management operations for Managed Care Organizations (MCOs) participating in the HealthChoice Illinois (HCI) program and programs serving people eligible for both Medicare and Medicaid. The role ensures contract compliance, drives performance improvements, and supervises MCO Account Managers. It also represents HFS in high-level stakeholder meetings and leads initiatives to strengthen managed care operations and service delivery for Medicaid members statewide. The position is a full-line supervisory role responsible for stakeholder representation and executive communications, performance management, research and benchmarking, policy development, and reporting, analytics, and governance. It is based at HFS headquarters in Chicago, with a hybrid schedule availability of two to five days per week in the office depending on operational needs. Applicants from Sangamon County are also welcome to apply. Travel, including overnight stays when appropriate, and overtime may be required. The position is a four-year term appointment, renewable at the department director’s discretion.
Requirements
- Education equivalent to completion of four years of college, with coursework in health administration, public policy, public administration, business administration, or a related field.
- At least four years of progressively responsible administrative experience in a public or private organization overseeing Medicare programs, including dual eligibility.
- Ability to complete a background check and disclose criminal history.
- Ability to use and maintain state-issued equipment, such as a laptop.
- Ability to travel for work, including overnight stays when appropriate.
- Ability to work overtime, which may include scheduled, unscheduled, or last-minute overtime, evenings, and weekends.
Nice To Haves
- Four years of professional experience developing and implementing policies within a healthcare or medical organization.
- Four years of healthcare industry experience, including direct experience with Medicare and Medicaid programs.
- Four years of experience establishing and maintaining effective relationships with internal and external stakeholders, including executive leadership, and addressing sensitive or controversial issues with sound judgment, tact, and professionalism.
- Four years of professional experience ensuring contract compliance for managed care health plans, including compliance with applicable federal, state, and organizational regulations.
- Four years of experience designing, implementing, and evaluating new or revised methods, procedures, and performance standards in a healthcare setting.
- Four years of experience supervising staff and managing team performance.
- Four years of experience involving knowledge of medical concepts and operations, preferably related to managed care health plans.
Responsibilities
- Oversee account management for MCOs participating in HealthChoice Illinois and programs related to people eligible for both Medicare and Medicaid.
- Ensure MCO contract compliance and drive performance improvements.
- Represent the Bureau of Managed Care in internal and external meetings, including routine and ad hoc discussions with MCOs and HFS executive leadership.
- Oversee performance management processes for programs serving people eligible for Medicare, Medicaid, and HealthChoice Illinois.
- Serve as a full-line supervisor and supervise MCO Account Managers.
- Lead research, benchmarking, and policy development.
- Lead reporting, analytics, and governance processes.
- Lead initiatives to strengthen managed care operations and service delivery for Medicaid members statewide.
- Perform other duties as required or assigned that are reasonably within the scope of the position.
Benefits
- Health, life, vision, and dental insurance
- Pension plan
- Paid parental leave
- Deferred compensation and other pre-tax benefit programs, including medical and daycare
- 12 paid sick days annually
- 10 paid vacation days in the first year, with the opportunity to earn up to 25 days annually
- 3 paid personal days annually
- 13–14 paid holidays annually, depending on start date
- Flexible work schedules are available in many program areas
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What This Job Offers
Job Type
Full-time
Career Level
Senior
