VP, Market Operations – Preferred Experience in Managed Care, Ohio

This is a fully remote position, open to applicants in Ohio.

📋 Description

• Formulate the comprehensive strategy and business objectives for the Ohio market program.

• Spearhead alignment and collaboration efforts to position CareSource as a leader in member and provider engagement, experience, and management of plans.

• Supervise over five products within the market to ensure they are profitable, compliant, and experiencing growth.

• Direct the Market leadership team in establishing both strategic and operational objectives.

• Manage a member base exceeding 500,000 across the market.

• Identify opportunities for growth strategies and product diversification.

• Build and maintain relationships with partners and stakeholders to facilitate market and product expansion.

• Convert business and program visions into actionable operational tactics and organizational frameworks.

• Lead the implementation of programs in new markets, allocate necessary resources, and ensure smooth ongoing operations.

• Create post-implementation strategies and objectives to mitigate potential program risks.

• Oversee the daily operations and operational controls of the market program.

• Conduct regular business reviews with stakeholder groups, including HR, IT, Finance, quality improvement, and Care4U.

• Develop, articulate, and execute market strategies alongside operational requirements.

• Align organizational goals and priorities with the leadership team.

• Ensure that both short-term and long-term strategic priorities are met efficiently and effectively.

• Oversee staffing resources and operational responsibilities within the market.

• Initiate operational plans and enhance cross-functional capabilities.

• Collaborate with Corporate Compliance to address issues, maintain compliance with contracts, and translate regulatory procedures into operational results.

• Work with Finance and Data Management on both internal and external compliance reporting.

• Manage departmental finances, budgets, and sales projections.

• Perform additional duties as assigned.

⛳️ Requirements

• A Bachelor of Science degree in finance, business, or a healthcare-related field, or equivalent work experience is mandatory.

• A Master’s degree is preferred.

• A minimum of five (5) years of experience in health plan operations is required.

• Five (5) years of experience leading division and corporate initiatives aimed at driving systemic change and promoting consumer engagement with health insurance is necessary.

• Five years of management experience in a managed care environment is essential.

• Intermediate proficiency in Microsoft Office is required.

• Familiarity with product requirements covering regulatory, operational, clinical, reporting, and compliance aspects is essential.

• Strong acumen in Health Plan Financial & Administration Management.

• Proven strategic management skills.

• Excellent conflict resolution abilities.

• Skills in planning, problem identification, and resolution are necessary.

• An influenza vaccination is mandated as a condition of continued employment during the influenza season (October 1–March 31); employees hired during this period have 30 days to complete it.

• Willingness to travel as required by business needs.

🏝️ Benefits

• Performance-based bonus linked to both company and individual achievements.

• Comprehensive total rewards package.

• Support for influenza vaccination requirements and immunizations.

• Reasonable accommodations available for qualified individuals with disabilities, medical conditions, or sincerely held religious beliefs.

• Ability to travel as needed for business purposes.