Sr. Director, Network Strategic Initiatives and Vendor Performance(Preferred Experience In Durable Medical Equipment & Preferred Location Northeast)

Job Summary:

The Senior Director, Marketplace Performance and Strategy leads the development of the Marketplace program strategy across the enterprise, execution of complex performance analysis and monitoring to significantly enhance business operations and/or revenue within a current or future market.

Essential Functions:

• Responsible for the development of the overall Marketplace Program Strategy, working with Enterprise functional areas and the Markets to align program strategy and goals for each market
• Lead the development and execution of enterprise strategies to improve market/business performance and/or achieve long term strategic goals 
• Establish and strengthen trusted advisor relationships with Enterprise functional business leaders and Market leadership including the Plan President, Market CFO and Market Operations leader
• Achieve a strong understanding of the Marketplace program elements that drive performance such as risk adjustment, forecasting, sales channels or member acquisition strategies and QAI tactics related to appropriate plan utilization
• Partner with stakeholders to develop Marketplace program KPIs and metrics supporting the Marketplace Enterprise and Market strategy
• Evaluate administrative spend for the Marketplace program and work with the business to identify and complete admin savings initiatives that align spend to Marketplace program goals
• Execute Enterprise strategic initiatives as it relates to performance / process improvements
• Partner with the Consumer Experience team to identify and execute enterprise / market-level consumer improvement initiatives to improve member retention and/or member satisfaction
• Ensure performance improvements are shifted into implementation process with EPMO and market implementation teams
• Accountable for hiring, training, coaching, professional development, succession planning, performance appraisals and disciplinary actions, and motivating collaboration and performance
• Develop budget for area of responsibility
• Perform any other job related instructions as requested

Education and Experience:

• Bachelor’s degree in related field or equivalent years of relevant work experience is required
• Master’s degree in a related field is preferred
• A minimum of seven (7) years of experience driving performance and process improvements, is required in the health care insurance industry
• Minimum of five (5) years of leadership and management is required
• Experience in cross-functional health care insurance operations such as the following is required:  Finance/Actuarial, sales/marketing, consumer experience/call center, grievance and appeals, population health management, including behavioral health, wellness, pharmacy and ancillary benefits, provider contracting, credentialing, enrollment, pricing, services and data maintenance, enrollment and revenue cycle operations, claims and encounters, and member and benefits configuration.
• Experience with Government-regulated (Federal and/or State) health insurance products including Medicaid, Medicare and Marketplace is required 

Competencies, Knowledge and Skills:

• Ability to lead direct reports and matrixed teams to successfully deliver complex initiatives within budget and against immovable deadlines
• Extensive knowledge of Project Management methodologies
• Exceptional collaboration, relationship building, and influencing skillset
• Flexibility in leading organizational change
• Exceptional planning and time management skills
• Excellent listening and critical thinking skills
• Excellent decision-making and problem-solving skills
• Ability to effectively interact at all levels within the organization
• Excellent written and verbal communication skills
• Hands on proficiency in Microsoft Office tools, including Project, Outlook, Word, PowerPoint and Excel
• Business acumen and politically astute ability to act with diplomacy and sensitivity to cultural diversity
• Ability to work independently and within a team environment

Licensure and Certification:

• Certified Six Sigma Black Belt is preferred
• Program Management Professional® is preferred

Working Conditions:

• General office environment; may be required to sit/stand for long periods of time
• Infrequent, short-term travel may be required

Compensation Range:

$135,600.00 - $237,400.00

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Salary

Organization Level Competencies

• Fostering a Collaborative Workplace Culture

• Cultivate Partnerships

• Develop Self and Others

• Drive Execution

• Influence Others

• Pursue Personal Excellence

• Understand the Business

 

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

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