AVP, Dual Products
CareSource
full-time
Posted on:
Location Type: Hybrid
Location: Florida • United States
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Salary
💰 $150,000 - $300,000 per year
Job Level
About the role
- Collaborates closely with both Market and Corporate Leadership to ensure the effective delivery of care for multiple markets
- Accountable for collaborating with Market and Corporate Leadership to support the strategy and operations of dual product care management
- Responsible for providing direction and oversight of dual product care management activities across the continuum and coordination of care
- Ensure programs and operational processes within regional markets are properly developed and aligned with the corporate Care Management model
- Assign appropriate priorities according to the overall business plan
- Lead, implement, develop, and support programs, systems, and processes to ensure consistent, effective, and efficient delivery of care to CareSource complex and dual product members while meeting state regulations and market financial objectives
- Cultivate and promote the CareSource culture to improve the health outcomes of our members
- Develop, implement, and monitor an accountability system and succession planning strategies
- Monitor CQI activities and process improvement in accordance with regulatory requirements, URAC, HEDIS, NCQA, and future business needs related standards
- Foster external and internal relationships with hospitals, physicians, community agencies, and key vendors
- Budget responsibility related to clinical care, direct actions to control targeted costs for inpatient and outpatient services in conjunction with market Medical Directors and corporate clinical and analytics leadership
- Review periodic reports (financial/utilization/services) to analyze trends, implement timely corrective action plans, and ensure consistent, accurate data according to established policies and procedures
Requirements
- Bachelor's degree in Business, health care or other related field required
- Master's degree preferred
- Equivalent years of relevant work experience may be accepted in lieu of required education
- Ten (10) years of clinical operations leadership and/or case management, disease management, medical management, quality improvement, related experience required
- Five (5) years of senior level management experience required
- Five (5) years of Managed Care experience in a multi-market organization required
- Experience in a collaborative matrix environment preferred
- Microsoft Office proficiency
- Clinical data analysis and trending skills
- Strong knowledge of healthcare regulations, quality improvement methodologies, and population health management
- Excellent analytical, problem-solving, and decision-making skills
- Commitment to the mission and values of the CareSource Family of Companies
- Strong oral, written and interpersonal communication skills
- Knowledge of regulatory reporting and compliance requirements
Benefits
- CareSource offers a substantial and comprehensive total rewards package
- Influenza vaccination is a requirement of this position
- Reasonable accommodations to qualified individuals with disabilities or medical conditions
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
clinical operations leadershipcase managementdisease managementmedical managementquality improvementclinical data analysisbudget managementregulatory reportingpopulation health managementdata analysis
Soft Skills
collaborationproblem-solvingdecision-makinginterpersonal communicationanalytical skillsleadershipstrategic planningrelationship buildingaccountabilitycommitment to mission