Hybrid AVP, Dual Products

at CareSource

• Job title: AVP, Dual Products
• Job type: Full Time
• Experience level: Lead
• Salary: $150,000 - $300,000 per year
• Degree requirement: Bachelor's Degree
• Location requirements: Hybrid, United States

About the role

• Associate Vice President overseeing dual product care management aligned with corporate goals and enhancing member care in multiple markets. Leading strategy implementation and ensuring operational efficiency in clinical care services.

Responsibilities

• Collaborates closely with both Market and Corporate Leadership to ensure the effective delivery of care for multiple markets
• Accountable for collaborating with Market and Corporate Leadership to support the strategy and operations of dual product care management
• Responsible for providing direction and oversight of dual product care management activities across the continuum and coordination of care
• Ensure programs and operational processes within regional markets are properly developed and aligned with the corporate Care Management model
• Assign appropriate priorities according to the overall business plan
• Lead, implement, develop, and support programs, systems, and processes to ensure consistent, effective, and efficient delivery of care to CareSource complex and dual product members while meeting state regulations and market financial objectives
• Cultivate and promote the CareSource culture to improve the health outcomes of our members
• Develop, implement, and monitor an accountability system and succession planning strategies
• Monitor CQI activities and process improvement in accordance with regulatory requirements, URAC, HEDIS, NCQA, and future business needs related standards
• Foster external and internal relationships with hospitals, physicians, community agencies, and key vendors
• Budget responsibility related to clinical care, direct actions to control targeted costs for inpatient and outpatient services in conjunction with market Medical Directors and corporate clinical and analytics leadership
• Review periodic reports (financial/utilization/services) to analyze trends, implement timely corrective action plans, and ensure consistent, accurate data according to established policies and procedures

Requirements

• Bachelor's degree in Business, health care or other related field required
• Master's degree preferred
• Equivalent years of relevant work experience may be accepted in lieu of required education
• Ten (10) years of clinical operations leadership and/or case management, disease management, medical management, quality improvement, related experience required
• Five (5) years of senior level management experience required
• Five (5) years of Managed Care experience in a multi-market organization required
• Experience in a collaborative matrix environment preferred
• Microsoft Office proficiency
• Clinical data analysis and trending skills
• Strong knowledge of healthcare regulations, quality improvement methodologies, and population health management
• Excellent analytical, problem-solving, and decision-making skills
• Commitment to the mission and values of the CareSource Family of Companies
• Strong oral, written and interpersonal communication skills
• Knowledge of regulatory reporting and compliance requirements

Benefits

• CareSource offers a substantial and comprehensive total rewards package
• Influenza vaccination is a requirement of this position
• Reasonable accommodations to qualified individuals with disabilities or medical conditions