Senior Director Medicare Ops

Primary City/State:

Arizona, Arizona

Department Name:

Sales

Work Shift:

Day

Job Category:

General Operations

Your pay and benefits are important components of your journey at Banner Health. This opportunity includes the option to participate in a variety of health, financial, and security benefits. In addition, this position may be eligible for our Management Incentive Program as part of your Total Rewards package.

Banner Health Network (BHN) is an accountable care organization that joins Arizona's largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. Through BHN, known nationally as an innovative leader in new health care models, insurance plans and physicians are coming together to work collaboratively to keep members in optimal health, while reducing costs.

POSITION SUMMARY
This position directs the operations of Banner Plans and Networks government owned health plans including marketing, government programs, member retention, network administration, and medical management administration departments. Responsible for ensuring cross-organizational collaboration of operational teams within the Banner Insurance Division, specifically with Banner Population Health Service Organization (BPHSO) to include the management of several level agreement between BUHP and BPHSO. This position will have a direct interface with the Arizona Medicaid Agency (AHCCCS), Center of Medicare and Medicaid Services (CMS), Association for Community Affiliated Plans (ACAP), and the Arizona Association of Health Plans (AzAHP).

CORE FUNCTIONS
1. Serves as the primary advisor to meet organization goals and objectives and has full budgetary accountability

2. Sets the department budget to meet organization goals and objectives and has full budgetary accountability

3. Sets the organizational policies, procedures, and practices. Sets internal controls to ensure that assets are safeguarded, policies and operating procedures are followed, necessary controls are effective and efficient, and compliance with current laws and regulations is achieved

4. Sets strategic direction and drives execution for functional areas.

5. Develops and provides oversight of service level agreement with cross functional operational areas including PHSO. Facilitates monthly operating report meeting designed to review status, progress and gaps as it relates to core operational/functional regulatory requirements.

MINIMUM QUALIFICATIONS

Bachelor's Degree in Business Administration in Health Care Administration or related field.

Depending upon assigned area of responsibility, position may require applicable certifications and/or licensures, including but not limited to: RN; MD or DO; Driver’s License; Certified Healthcare Protection Administrator (CHPA); Certified Protection Professional (CPP); Chartered Property Casualty Underwriter (CPCU); Associate in Risk Management (ARM); CPA; SPHR; Registered Health Information Administrator (RHIA); Registered Health Information Technologist (RHIT); Certified Healthcare Facility Manager (CHFM); Certified Facility Manager (CFM); Certified Coding Specialist (CCS); Certified Professional Coder (CPC); JD from an American Bar Association accredited school; admission to a State Bar Association.

Must possess a strong knowledge in management as normally obtained through the completion of a Bachelor's Degree in Business, Healthcare or related field, coupled with seven or more years of increasingly responsible administrative leadership experience in an integrated administrative services environment or large multi-operational, complex environment.

PREFERRED QUALIFICATIONS

Master’s degree preferred.

Additional related education and/or experience preferred.

EEO Statement:

EEO/Female/Minority/Disability/Veterans

Our organization supports a drug-free work environment.

Privacy Policy:

Privacy Policy