• Develops strategic plan for design and delivery of Health Services programs that optimize value for the Health Plan members and employers to effectively manage the health of the Health Plan membership.
• Assures implementation of department priorities to establish and maintain department goals, objectives, and service standards.
• Maintains operational responsibility for staffing to support quality, efficiency and customer service including staff job descriptions, performance evaluations, action plans, goal setting, hiring, promoting, disciplinary actions and establishment and delivery of initial and ongoing staff education programs.
• Provides supervision and guidance for all department staff and maintains direct responsibility for Health Services operations.
• Develops a thorough understanding and effectively communicates the products and services of the Health Plan's Health Services team to current and potential clients.
• Communicates changes in rates, services, activities, and other information related to Health Services initiatives.
• Establishes schedule with employer groups to recommend population specific health services products based upon the group's demographic profile, claims history and risk profile.
• Designs and implements Health Services programs in partnership with employers in compliance with federal regulations and health plan standards.
• Assures compliance of plan designs including member confidentiality and documentation and assures compliance with regulatory agencies.
• Ensures that appropriate policy and process is developed, implemented, and revised as directed by regulatory standards to include OSHA, Department of Insurance, HIPPA, etc.
• Oversees development of appropriate reporting dashboards, employer profiles to provide needed analytics for program participation and outcomes.
• Oversees special initiatives such as vaccination services at employer sites; development of partnerships with onsite medical clinics; and collaborative employer-based health promotion services.
• Oversees the establishment and delivery of initial and ongoing staff development programs.
• Manages employee communications, organization of events and other activities related to the Health Services initiatives.
• Establishes collaborative working relationships within and outside the organization to support the Health Plan and Health Services department goals, standards, and business strategies.

Work is typically performed in a clinical environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. Additional competencies and skills outlined in any department-specific orientation will be considered essential to the performance of the job related to that position.