We are looking for a Vice President, Health Plan Operations, to join us in leading our organization forward.
McLaren Integrated HMO Group (MIG) is a fully owned subsidiary of McLaren Health Care Corporation and is the parent company of McLaren Health Plan in Michigan and MDwise, Inc. in Indiana. It is an organization with a culture of high performance and a mission to help people live healthier and more satisfying lives.
McLaren Health Plan and MDwise, Inc., subsidiaries of MIG, value the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plans can thrive. As an employee of MIG, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members.
McLaren Health Plan is our Michigan-based health plan dedicated to meeting the health care needs of each of our Michigan members. Learn more about McLaren Health Plan at https://www.mclarenhealthplan.org.
MDwise is our Indiana-based health plan, working with the State of Indiana and Centers for Medicare and Medicaid Services to bring you the Hoosier Healthwise and Healthy Indiana Plan health insurance programs. Learn more about MDwise, Inc. at https://www.mdwise.org/.
Position Summary:
Assumes responsibility for establishing, directing, evaluating and coordinating daily health plan operations to meet member engagement performance requirements. This position is part of the Health Plan executive management team and has direct oversight of the member experience in customer service, outreach, marketing, credentialing and project management areas. In addition, oversees procurement responses, new product implementations and complex initiatives utilizing cross-functional teams to meet strategic objectives.
Responsible for responding to issues involving performance across all areas of call center and member engagement operations and driving solutions that result in efficiency and better outcomes for our members. Lead key strategic initiatives and provide strategic project management direction on for large, complex initiatives in order to ensure programs and strategies are implemented across the health plan and achieve established goals for member and provider satisfaction. Provides administrative direction for the operation of assigned departments and appraises the performance of respective department heads. Builds, develops and manages teams capable of carrying out needed initiatives. Communicates routinely with the Market President, peers, and leadership, concerning policy recommendations and suggested course of action pertinent to the operation of assigned departments. Provides and communicates pertinent information throughout the Health Plan and to the respective governing bodies.
This is a leadership position, with requirements to come onsite, Flint MI, as required by the leader.
Equal Opportunity Employer of Minorities/Females/Disabled/Veterans
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Qualifications:
Required:
Bachelor’s degree in business administration, health care or related field.
Five (5) years’ experience in a senior leadership role with an HMO or managed care organization with demonstrated managerial experience in establishing and overseeing health plan operations including member service and engagement strategies, and direct interaction with health care providers and regulators.
Preferred:
Master’s degree in business administration or health-related field.
Three (3) years’ experience in a progressively more responsible project management role in a health care environment. Project Management Professional (PMP) certification preferred.
Experience and knowledge of HMO, PPO, TPA, PHO and Managed Care functions (e.g. accounting/finance, reinsurance, EDI, case management, marketing, medical delivery, regulatory compliance, claims processing, eligibility, contracting and risk arrangements and actuarial precepts).