VP, Market Operations(Preferred Experience in Managed Care & Live In Ohio))

CareSource•Ohio WFH, OH

9d•$150,000 - $300,000

About The Position

The Vice President, Market Operations – Ohio develops the market’s overall program strategy and business objectives and leads alignment and collaboration to establish CareSource as an industry leader in member and provider engagement, experience, and plan management. The role oversees more than five market products and more than 500,000 members, with responsibility for profitability, compliance, growth, and the achievement of strategic and operational goals. This position translates business and program vision into operational tactics, organizational support, and infrastructure. It oversees day-to-day market operations and controls, leads implementation in new markets, allocates resources, manages operational plans, and conducts regular business reviews with internal stakeholder groups. The role also supports market growth and product expansion, maintains contract and regulatory compliance in collaboration with corporate compliance, develops reporting with Finance and Data Management, and works with management on departmental finances, budgets, and sales forecasts. The position is based in a general office environment and may require extended periods of sitting or standing and travel as business needs require. Annual influenza vaccination is required for designated positions during influenza season, subject to the stated timing and accommodation provisions. The compensation range is $150,000–$300,000, with potential eligibility for a performance-based bonus and a comprehensive total rewards package.

Requirements

Bachelor of Science degree in finance, business, or a health care field, or equivalent work experience.
Five years of health plan operations experience, such as claims, enrollment, or provider agreements.
Five years of experience leading division and corporate initiatives to drive systemic change and consumer adoption of health insurance and engagement initiatives.
Five years of management experience in a managed care setting.
Intermediate proficiency with Microsoft Office.
Knowledge of product requirements across regulatory, operations, clinical, reporting, and compliance areas.
Critical listening and systematic thinking skills.
Ability to attract, manage, and develop team members.
Ability to maintain confidentiality and act in the company’s best interest.
Oral, written, and interpersonal communication skills.
Leadership experience and skills.
Energetic, enthusiastic, and politically astute approach.
Ability to act with diplomacy and sensitivity to cultural diversity.
Responsiveness to a changing environment.
Health plan financial and administration management acumen.
Strategic management skills.
Conflict resolution skills.
Planning, problem identification, and resolution skills.
Annual proof of influenza vaccination during the specified influenza season is required for designated positions as a condition of continued employment; employees hired during the season have 30 days from their hire date to complete the vaccination and verify immunization, subject to applicable accommodations.

Nice To Haves

Master’s degree.
Preferred experience in managed care.
Live in Ohio.

Responsibilities

Develop the overall market program strategy and business objectives, and lead alignment and collaboration around member and provider engagement, experience, and plan management.
Oversee more than five products within the market to support profitability, compliance, and growth.
Lead collaboration with the Market leadership team to establish strategic and operational goals.
Manage operations for more than 500,000 members across the market.
Identify additional growth strategies and product diversification opportunities.
Establish key relationships with partners and stakeholders associated with market and product expansion.
Translate business and program vision and strategy into operational tactics, organizational support, and infrastructure.
For new markets, lead program implementation, allocate implementation resources, facilitate ongoing operations, and establish post-implementation strategy and goals to mitigate risks.
Oversee day-to-day market program operations and establish controls to ensure requirements are met.
Lead regular market business reviews with stakeholder groups, including human resources, information technology, finance, Business Partner Group, quality improvement, and Care4U.
Develop, translate, and execute key market strategies and functional or operational requirements.
Facilitate the leadership team’s establishment of organizational goals and priorities.
Ensure market operations achieve short- and long-term strategic priorities effectively and efficiently.
Oversee staffing resource and responsibility allocation for market operations.
Initiate and oversee operational plans and initiatives to create cross-functional capabilities.
Work with corporate compliance to escalate and resolve issues, maintain contract compliance and responsiveness, understand the regulatory environment, and translate regulatory procedures into policies, plan changes, reporting, or other operational outcomes.
Collaborate with Finance and Data Management to develop internal management reporting and external compliance reporting.
Work with management to oversee departmental finances and ensure budgets and sales forecasts are met.
Perform other job duties as requested.