Note: The job is a remote job and is open to candidates in USA. CareSource is a healthcare organization seeking an Integrated Care Program Operations Manager to support the Duals team in implementing, enhancing, and standardizing programs for dual-eligible members and LTSS models. The role coordinates operational strategies, manages risks and process improvements, supports product expansion, and collaborates with markets and stakeholders to improve program outcomes.
Responsibilities
- Collaborate with markets to implement business strategies and operational plans to ensure core functionality, scalability, and ongoing department management to support LTSS (HCBS and NH) model
- Support the translation of business and program vision and strategy into operational tactics - collaborating to build the necessary organizational support and infrastructure
- Support post implementation strategy and goals to mitigate program risks
- Support the evaluation of operational process effectiveness for accomplishing market goals and objectives; manage operation process improvement activities in collaboration with market teams
- Coordinate, translate, and execute key strategies for functional/ operational requirements
- Provide leadership and support for product expansion
- Incorporates industry standard, best practice project management tools and techniques in market initiatives
- Recognizes and proactively manages operational dependencies and risks across market operations initiatives portfolio through effective change and risk management controls
- Works closely with leadership to establish, communicate, and perpetuate the corporate vision, ensuring appropriate communication to stakeholders
- Monitors performance across markets LTSSS/HCBS programs to leverage best practice and knowledge sharing for the purpose of improving outcomes through the standardization of evidence-based practices
- Assists the dual eligible President with the monitoring of legislative/governmental activities with the goal of advocating for the full integration LTSS/HCBS standard model, identifying opportunities and issues
- Interacts heavily within Dual Eligible, LTSS program business partners, and builds strong working relationships with all markets
- Engages stakeholders to ensure alignment
- Leads activities ensuring the delivery of high quality, consistent initiatives that result in optimum outcomes for members, providers, and program goals
- Perform any other job related duties as requested
Skills
- High School or GED required
- Four (4) years of clinical operations/healthcare administration experience required
- Four (4) years of experience driving performance and process improvements, is in the health care insurance industry required
- Able to effectively identify business problems, assess proposed solutions, and understand the needs of business partners and stakeholders
- Ability to communicate effectively with all levels of leadership
- Develops effective working relationships with business partners and stakeholders
- 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
- Ability to think critically and lead with strategy
- Comprehensive knowledge base crossing all the following areas: 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
- Up to 15% (occasional) travel based on the needs of the department may be required
- Bachelor's degree preferred
- Three (3) years Experience with Government-regulated (Federal and/or State) health insurance products including Medicaid, Managed Care Waiver, FFS and Medicare preferred
- Three (3) years Experience implementing programs with focus on integration preferred
- Three (3) years Project management experience preferred
Benefits
- You may qualify for a bonus tied to company and individual performance.
- Remote work
- A substantial and comprehensive total rewards package
Company Overview
Company H1B Sponsorship