Associate Chief Operating Officer, Health Plan Services
West Chicago, IL
Permanent
Full-time
9 days ago
The final salary and offer components are subject to additional approvals based on Cook County Health (CCH) policy. Your placement within the salary range is dependent on a number of factors including your work experience and internal equity within this position classification at CCH. For positions that are represented by a labor union, placement within the salary range will be guided by the rules in the collective bargaining agreement.LOCATION/DEPT: Health Plan ServicesSHIFT: 8:30 AM – 4:30 PMNON-UNIONJob TitleHealth Plan ServicesDepartmentHealth Plan ServicesThis position is exempt from Career Service under the CCH Personnel Rules.Job SummaryThe Associate Chief Operating Officer, Health Plan Services, assists in leading the operations of health plan services for Medicaid Managed Care Plan product lines, Medicare Advantage Plan Services product lines and other lines of business (LOB). Works with the Chief Operating Officer (COO) to oversee the Third-Party Administrator (TPA) contractor(s) as well as all vendors and delegates including working with Cook County Health (CCH) financial planning staff and medical group leaders to develop, monitor, and evaluate operating costs and external expenditure budgets, in order to ensure optimal financial and operational performance of the CCH managed care system. This position is responsible for managing all relations with TPAs, delegates and vendors which are external contracted entities.General Administrative ResponsibilitiesCollective BargainingReview applicable Collective Bargaining Agreements and consult with Labor Relations to generate management proposalsParticipate in collective bargaining negotiations, caucus discussions and working meetingsDisciplineDocument, recommend and effectuate discipline at all levelsWork closely with labor relations and/or labor counsel to effectuate and enforce applicable Collective Bargaining AgreementsInitiate, authorize and complete disciplinary action pursuant to CCH system rules, policies, procedures and provision of applicable collective bargaining agreementsSupervisionDirect and effectuate CCH management policies and practicesAccess and proficiently navigate CCH records system to obtain and review information necessary to execute provisions of applicable collective bargaining agreementsManagementContribute to the management of CCH staff and CCH’ systemic development and successDiscuss and develop CCH system policy and procedureConsistently use independent judgment to identify operational staffing issues and needs and perform the following functions as necessary; hire, transfer, suspend, layoff, recall, promote, discharge, assign, direct or discipline employees pursuant to applicable Collective Bargaining AgreementsWork with Labor Relations to discern past practice when necessaryTypical DutiesAssists in leadings the operations of health plan services for Medicaid Managed Care Plan product lines, Medicare Advantage Plan Services product lines and other of LOB.Provides support to the COO in directing, managing, coordinating and assuring implementation of provider contracting and relations through working with the TPAs, delegates and vendors.In conjunction with the COO, develops & implements programs that support achievement of established patient satisfaction targetsDevelops and implements tools for monitoring and evaluating performance objectives and compliance for all contracts, including the TPA and provider contractsManages and resolves operational issues, such as assuring claims are being paid in a timely manner, call centers are functioning properly, contracted providers are informed about managed care policies and procedures, etc.Identifies and monitors trends in enrollment, growth, retention, and expenditures, etc.Develops and implements resolution plans pertaining to overall health plan operationsCollaborates with the COO to facilitate Plan requirements with managed care initiativesAnalyzes and reports on the status of functional services and any care provided outside the health systemWorks with the COO to develop systems and approaches that integrate member health planning & care delivery to ensure the provision of the appropriate type & level of service in a timely mannerAssists with the care delivery strategy and operations, in partnership with the CCH managed care Medical Director and Director of Business DevelopmentAccountable for achieving defined objectives including membership, financial, regulatory, member satisfaction and quality outcomes.Assures that the implementation of provider contracts meet access, accreditation and regulatory requirements and are consistent with Managed care policiesAchieves and exceeds performance expectations for Managed care operations consistent with TPA and provider contractual performance measuresPerforms other related duties as requestedQualificationsMinimum QualificationsBachelor's degree from an accredited college or university, is required (must provide official transcripts at time of interview)Five (5) years of Managed Care experience in Medicaid and Medicare, is requiredFour (4) years of management experience with at least three (3) years of experience at a director level or higher in a healthcare environment, is requiredExperience and knowledge of health plan operations and demonstrated ability to achieve results on both strategic and operational level, is requiredExperience and working knowledge of quality assurance, resource management, health plan regulatory and licensing processes including federal and state laws and regulations, is requiredPreferred QualificationsMaster's degree from an accredited college or university, is preferred (must provide official transcripts at time of interview)Prior experience in a leadership role within an urban, publicly supported, health system, is preferredKnowledge, Skills, Abilities and Other CharacteristicsStrong problem-solving skills used to anticipate and identify issues and to develop and implement appropriate solutions related to complex administrative processesStrong interpersonal skills are critical as this position works closely with the TPA, other external customers, and internal members of the Managed care leadership team, internal finance and IT managers and other members of CCH leadershipStrong verbal and written communication skills as this position will frequently present data, trends and performance results to members of upper management and CCH leadershipStrong project management skillsDemonstrated ability to lead and manage change through the use of interpersonal skills such as negotiating, collaborating, and influencingStrong knowledge of Microsoft Office products (Word, Excel, Access, PowerPoint, etc.)Physical and Environmental DemandsThis position is functioning within a healthcare environment. The incumbent is responsible for adherence to all hospital and department specific safety requirements. This includes but is not limited to the following policies and procedures: complying with Personal Protective Equipment requirements, hand washing and sanitizing practices, complying with department specific engineering and work practice controls and any other work area safety precautions as specified by hospital wide policy and departmental procedures.The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of the personnel so classified.For purposes of the American with Disabilities Act, “Typical Duties” are essential job functions.VETERAN PREFERENCEWhen applying for employment with Cook County Health & Hospitals System preference is given to honorably discharged Veterans who have served in the Armed Forces of the United States for not less than 6 months of continuous service, who was not dishonorably discharged.To take advantage of this preference a Veteran must:MEET THE MINIMUM QUALIFICATIONS FOR THE POSITION.· IDENTIFY AS A VETERAN ON THE EMPLOYMENT APPLICATION BY ANSWERING YES TO THE QUESTION “Are you a Military Veteran?”· ATTACH A COPY OF THE VETERANS DD214, DD215 or NGB 22(NOTICE OF SEPARATION) AT TIME OF APPLICATION FILING.PLEASE NOTE: IF YOU HAVE MULTIPLE DD 214S, 215S, OR NGB 22S, PLEASE SUBMIT THE ONE WITH THE LATEST DATE. COAST GUARD MUST SUBMIT A CERTIFIED COPY OF THE MILITARY SEPARATION FROM EITHER THE DEPARTMENT OF TRANSPORTATION (BEFORE 911) OR THE DEPARTMENT OF HOMELAND SECURITY (AFTER 911).VETERANS MUST PROVIDE ORIGINAL APPLICABLE DISCHARGE PAPERS AT TIME OF INTERVIEW.Benefits Package
Medical, Dental, and Vision Coverage
Basic Term Life Insurance
Pension Plan and Deferred Compensation Program
Employee Assistance Program
Paid Holidays, Vacation, and Sick Time
You may also qualify for the Public Service Loan Forgiveness Program (PSLF)
For further information on our excellent benefits package, please click on the following link:MUST MEET ALL REQUIRED QUALIFICATIONS AT TIME OF APPLICATION FILING.Degrees and transcripts from non-U.S. accredited institutions must be translated and certified to the US equivalent academic credentials by a recognized US education interpreter serviceCOOK COUNTY GOVERNMENT IS AN EQUAL OPPORTUNITY EMPLOYER