Manager of Health Plan Operations

Location: Phoenix, AZ
Date Posted: 03-12-2018
Manager of Health Plan Operations - Medical Management
Phoenix, AZ
Manager of Operations Job Summary: 
  • The Manager of Health Plan Operations is an engaged change leader who builds coalitions that investigate and take action on meaningful community health issues.
  • Partners with providers, internal teams and the community to create innovative models designed to advance healthcare quality, improve the health status of members, and moderate system-wide cost trends.
  • Represents the company on high-profile projects designed to improve the health status of members and the designated population.
  • In partnership with the CMO, formulates healthcare strategies for the organization.
  • Assist CMO to develop, organize, and create innovations and programs designed to foster and enhance relations between the health plan, its subsidiaries and affiliates, hospitals, and providers.
  • Provide written information through letters and articles in newsletters, emails, and other publications to educate members, prospects, employees, and the community on key healthcare issues.
  • With CMO, set the strategic direction for data analysis. Partner with informatics and healthcare economics to create models focused on identifying cost trends and systemic waste. Develop programs to address findings.
  • Articulate innovations to marketing to assist with development of educational materials and promotions surrounding provider understanding and acceptance of managed care initiatives or procedures. 
Manager of Operations Background: 
  • Prefer, but does NOT require, an active or expired Registered Nurse (R.N.) license.
  • Requires Bachelor of Science (B.S.) or Bachelor of Arts (B.A.), in public health, healthcare administration, business administration, nursing, or related field. Master’s degree preferred.
  • Project Management Professional Certification (PMP) is a plus.
  • 3 years of experience in healthcare administration including, but not limited to quality review, utilization review, and managed care functions
  • 5 years of experience in developing short and long range strategic plans, forecasting, and budgeting
  • Requires 2-5 years of leadership experience as a Supervisor or Manager.
  • Proficiency with Microsoft Office applications
  • Excellent analytical, oral and written communication skills
  • Ability to work with diverse stakeholders and think strategically.
CareNational Healthcare Services
480.478.1635 (CALL – TEXT – FAX)
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