The Chief Operating Officer (COO) is responsible to oversee the day to day operations of all the Managed Care Products at the direction of the Executive Director. This position will define, implement operations strategy, structure and processes, ensuring development of efficient and cost effective systems to meet current and future needs of the organization.
Essential Responsibilities:
• Executive-level vision and a strong connection to the organizations mission
which will be conveyed daily throughout all departments.
• Contributes to short and long-term strategic planning for program growth with
department leadership. Implements the strategy to meet the growth targets.
• Develops a deep understanding of current and future business needs and
establishes operational priorities.
• Develops and oversee workflows of overall operations and manages the outcomes
of the following departments: Quality, Intake and Enrollment, Member Services,
Utilization Management, Disease Management and Care Management.
• Ability to communicate information whether technical or non-technical to staff
in a clear and concise manner.
• Ability to streamline departments based on business needs and implements
strategic planning regarding company growth
• Collaborates with executive leadership to develop and meet company goals
while supplying expertise and guidance on operations projects and systems.
• Collaboration with other departments to gain an in-depth understanding of its
processes, with the goal of achieving efficient outcomes for growth and success
• Ensures adequate staffing of care management, member services, and utilization
management department in order to meet quality and performance targets.
• Ensures all practices are aligned with the overall strategic plan of the organization
and regulatory requirements.
• Improve core efficiency
• Lead and participate in meetings as necessary
• Monitor performance of reporting departments to proactively identify efficiency
issues and propose solutions. Also focuses on issues in delivering the desired
results, and solving those problems.
• Participating in Medicare Network design, service area expansion, compliance
audits, evaluation of network adequacy
• Provides leadership over projects designed to drive improvements to the Plan’s
Medicare star ratings, risk score, revenue optimization. Works with appropriate
departments to ensure that the Medicare program is exceeding quality standards
and contributing positively to Stars outcomes
Specific Knowledge, Skills, and Abilities:
• In depth knowledge and understanding of all the product lines under Hamaspik
Managed Care and its functions and principles
• Have an in-depth understanding of DOH and Medicare/CMS requirements and
regulations as it pertains to the products of the plan.
• Demonstrated ability to effectively prioritize and execute tasks in a high-pressure
environment and meet contractual timelines
• Proven ability to interpret and present information to enable senior
management and business stakeholders to make sound decisions
• Outstanding organizational and interpersonal skills.
Qualifications-
VP of operations or COO background
Experience with managed care (homecare or MLPC)
Must be able to multitask
Tech Savvy
Experience growing a company
Out of the box thinker
Dedicated
Growth oriented
Drive to be great