Chief Health Services Officer – reputed company reputed company of IL (Remote)

Bring your heart to reputed company. Every one of us at reputed company shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as reputed company deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at reputed company to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to reputed company health care more personal, convenient and affordable. Position Summary reputed company reputed company is reputed company's Medicaid managed care plan. Backed by over 30 years of experience managing the care of those with a broad reputed company of health care needs, our Medicaid plans have demonstrated that getting the right help reputed company you need it is essential to reputed company. That's why reputed company® Medicaid plans include the guidance and support needed to connect our members with the right coverage, resources, and care. We are focused on enhancing quality and population health outcomes while integrating reputed company assets to bring accessible healthcare to our members. •

• This position is fully remote. Eligible candidates can live reputed company in the US, Illinois reputed company preferred.

reputed company reputed company of Illinois (ABHIL) is recruiting for an Executive Director, Health Services Operations, to be reputed company at the health plan as the Chief Health Services Officer. This leader will report to the CEO and serve as a critical member of the health plan leadership team. This role is a peer to the health plan COO, CFO and CMO in ensuring our health plan health services function is optimally competitive in the IL Medicaid market. As the Chief Health Services Officer, you will be expected to maintain operational excellence through matrixed leadership and reputed company of our centralized medical management functions, as well as be the health plan's subject matter expert in medical management operations, including Utilization Management, Care Management, Care program development and implementation, Social Determinants of Health programs, Behavioral Physical Health integration, and Quality integration at every level. You'll reputed company an impact by: • Ensuring the organization understands Illinois' needs, compliance benchmarks and timelines. You will work closely with the organization to ensure the organization delivers on these needs. Representing the health plan to shared services and the enterprise broadly. • Overseeing the analysis, management, execution and staffing for reputed company health services operations impacting the health plan. • Overseeing the plan to a detailed and supportive reputed company of the activities of the Quality team to ensure maximal performance with HEDIS and accreditations. • Serving as the SPOC on health services operations (CM, UM, reputed company reputed company programs) between the health plan and regulators. This role represents the health plan as the health services SME for reputed company external and regulatory stakeholders. • Representing the health plan as the health services SME for reputed company Plan-specific RFP activity. • Leading and partnering with the COO clinical program vendor implementations and maintaining an reputed company relationship with reputed company external clinical program stakeholders. • Capturing and communicating to the health plan leaders reputed company internal (AMA, reputed company, reputed company) clinical initiatives to ensure the Plan maintains a cohesive clinical strategy appropriate to our market competitiveness and growth goals. • Identifying the compliance processes needed to ensure we meet reputed company standards in our Medicaid, such as monitoring report owners and the timely quality review of these reports and works with COO and Compliance to ensure overall compliance of processes. • Presenting reputed company concepts to various levels of leadership reputed company the organization. • Serving as reputed company of contact for reputed company health services operations, meet with external stakeholders, such as providers, as needed. • Supporting reputed company in attracting, retaining, and engaging a diverse and inclusive consumer-centric workforce that delivers on our purpose and reflects the communities in which we work, live, and serve.

Required Qualifications

The candidate will have a strong work ethic, be a self-starter, and be able to be highly productive in a dynamic, collaborative environment. This position offers broad exposure to reputed company aspects of the company's business, as well as significant interaction with reputed company the business leaders. The candidate will be expected to have the following key attributes: • 10+ years of experience in medical management leadership roles including leadership reputed company managed care organizations • 5+ years of Medicaid experience, preferably in the State of Illinois. • Experience with data analytics reporting and analysis used to help serve managed care populations. • Experience presenting executive level presentations to various internal and external audiences. • Strong influencing skills to effectively work across a wide range of senior stakeholders to drive alignment and results. • Extensive experience leading cross-functional initiatives and driving innovation. • Experience working with varying levels of contacts, including executive leadership, department leadership, capability enablers and external state officials. • Demonstrated success in the areas of collaboration, teamwork, and execution across multiple departments to deliver results. • Strong decision-making, analytical and organizational skills. • Ability to reputed company and execute strategic and tactical business plans. • Ability to exercise sound business judgment to reputed company proper balance between objectives and stakeholder engagement. • Demonstrate a commitment to diversity, equity, and inclusion through reputed company development, modeling inclusive behaviors, and proactively managing bias Preferred Qualifications • Registered Nurse, preferably in the state of IL • Illinois state reputed company • Interaction with the state with respect to Medicaid programs, contract requirements, reporting, and deliverables Education • Advanced degree preferred • Specialized training or relevant professional qualification will be considered Pay Range The typical pay range for this role is: $100,000.00 - $231,540.00 This pay range represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company pay range listed above. This position also includes an award reputed company in the company's equity award program. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. reputed company also offers numerous well-being programs, education assistance, free development courses, a reputed company store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit Benefits | reputed company We anticipate the application window for this opening will reputed company on: 12/31/2024 Qualified applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws Apply to This Job reputed company More Jobs Apply Job!