2 Clinical Operations-Business Strategy Lead - R7614 Jobs in Dayton, OH
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Clinical Operations-Business Strategy Lead - R7614
$159k-201k (estimate)
Full Time | Wholesale
2 Days Ago
CareSource is Hiring a Clinical Operations-Business Strategy Lead - R7614 Near Dayton, OH
Job SummaryClinical Operations – Business Strategy Lead serves a subject matter expert and serves as a liaison between internal clinical partners/designees to capture specific business requirements that must be performed by the Clinical Partner or Vendor and serves as a liaison between the Clinical Partner, Organizational Key Stakeholders and Vendors.
Essential Functions
Compensation TypeSalary
Competencies
Essential Functions
- Serve as the strategic partner’s advocate anticipating and resolving problems with the strategic partner. Utilizes partner feedback to determine and recommend best practices
- Coordinate between CareSource and clinical partners/vendors to maximize on the relationship and prevent escalations.
- Develop and maintain expertise in clinical business processes within assigned areas and recommend innovative enterprise level strategies while addressing market specific nuances
- Within assigned areas, develop issue prevention strategies, develop solutions, and participate in negotiating/implementing the chosen course of action
- Facilitate or serve on enterprise clinical committees on behalf of the strategic partner to address business process related needs
- Lead cross-functional meetings with stakeholders to guide the development of performance metrics feedback and identify opportunities in assigned projects
- Participate in the development of business cases on behalf of the clinical leads.
- Assist in the vendor selection process by participating in the RFI/RFP/RFQ process, developing total cost models, and participating in the assessment process
- Act as a liaison between the clinical leads and vendor throughout the vendor lifecycle
- Participate in joint operating committee meetings, and facilitate monthly operational meetings with business owners and delegated/non-delegated vendors
- Perform any other job duties as requested
- Bachelor’s degree in business, health administration, health policy or related discipline or equivalent years of relevant work experience is required
- Minimum of three (3) years of experience in managed care clinical programs is preferred
- Previous leadership experience is preferred
- Experience with Medicaid / Medicare or other government programs with highly regulated requirements is preferred
- Working knowledge of state, NCQA, and/or URAC requirements preferred
- Advanced proficiency level with Microsoft Office Suite including Outlook, Word, Excel and Power Point
- Strong project management skills with ability to handle multiple projects within time constraints
- Strong interpersonal and verbal/written communication skills with demonstrated ability to influence internal/ external constituents
- Ability to speak and effectively communicate in front of individuals and groups, vendors, and executive leadership
- Ability to interact with all levels of leadership, influence change, adoption of vendor management concepts, and lead cross-functional teams and initiatives
- Ability to manage complex responsibilities and decisions producing long-range outcomes
- Highly motivated individual with the ability to work independently in a fast paced environment with changing priorities
- Proficient in interpreting business, compliance and regulatory requirements
- None
- General office environment; may be required to sit or stand for extended periods of time
Compensation TypeSalary
Competencies
- Create an Inclusive Environment - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business
Job Summary
JOB TYPE
Full Time
INDUSTRY
Wholesale
SALARY
$159k-201k (estimate)
POST DATE
06/27/2024
EXPIRATION DATE
07/24/2024
WEBSITE
caresourceok.com
HEADQUARTERS
OKLAHOMA CITY, OK
SIZE
25 - 50
FOUNDED
1996
CEO
LARRY PIERCE
REVENUE
$5M - $10M
INDUSTRY
Wholesale
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