Company name
Humana Inc.
Location
Tulsa, OK, United States
Employment Type
Full-Time
Industry
Manager, Executive, Clevel, Operations, 100k
Posted on
Jun 07, 2023
Profile
Job Information
Humana
Regional VP, Operations Medicaid
in
Tulsa
Oklahoma
Description
The Chief Operating Officer (COO) establishes long-range goals, objectives, and plans and monitors financial and operational performance. They will be responsible for the strategic development and oversight of operations for Humana's Oklahoma Medicaid Plan. They will manage ongoing operations across multiple levels of the organization to meet operational Contract requirements and financial performance goals. They will be accountable for operational results. The COO represents the Plan externally and to State and external agencies.
Responsibilities
Directs and coordinates day-to-day plan functions, including Reporting, Claims Administration, Encounter Data Quality, Grievance and Appeals, Information Technology and Systems, Enrollee Services, Provider Services, and Business Continuity Planning and Emergency Coordination
Liaise among OHCA, plan leadership, and corporate contacts responsible for the execution of Contract deliverables
Works with the plan Chief Executive Officer to maintain important stakeholder relationships throughout Oklahoma
Leads internal infrastructure to review and improve operational functions
Manages implementation of strategic plans developed in cooperation with the Plan leaders
Oversees development and maintenance of operational policies and procedures
Effectively implements business plans and oversees audit processes
Owns execution of daily operating objectives and goals, including key performance metrics
Plans organizational growth and potential staff successions
Develops and cultivates a diverse and inclusive environment
Maintains intimate familiarity with Contractual requirements and stipulations
Understands and actively manages ongoing adherence to local, State, and federal regulatory and programmatic requirements
Mitigates risks potentially impacting the State of Oklahoma and the plan by proactively monitoring any risk factors and red flags that may arise during operations
Communicates with OHCA and direct plan/corporate leadership regarding any necessary operational or regulatory changes
Leads conflict resolution for any Provider relations or network issues that may occur
Required Qualifications
Bachelor's degree in Business, Operations Management, Healthcare Administration or related field
Minimum two (2) years of experience in health plan management
Four (4) to six (6) years of experience working in healthcare operations
Leadership background with more than five (5) direct-reports
Preferred Qualifications
Master's degree
Experience in strategic and thought leadership in supporting Medicaid health plans
Additional Information
This role is based in Oklahoma City
Role is leveled as RVP, Operations
Scheduled Weekly Hours
40
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.
Company info
Humana Inc.
Website : http://www.humana.com