Director of Health Plan Reporting and Operations
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Director of Health Plan Reporting and Operations
Ref No.: 17-19160
Location: Oakland, California, California
Intake call recording
Responsible for the management and leadership of a range of process improvement and process management activities. Activities managed include planning, performing, and implementing process improvement initiatives, in addition to ownership of operational processes. These initiatives may represent one portion of a larger project, or may represent a stand alone initiative or function within a work group or department. Process management functions may include data gathering and analysis, best practice research, process mapping, developing and recommending alternatives for improvement, developing performance metrics, obtaining leadership or stakeholder agreement, implementing improvements, and monitoring post-process improvement initiative performance to updated standards. Activities are undertaken and executed in support of organizational goals and are accountable for providing business process solutions to meet internal and external customer expectations.

Essential Responsibilities:
· Resource Management: Manages extremely complex organization(s) that may include multiple lines of business. Manages the efforts of direct and indirect reports, and collaborates with, provides guidance to and influences employees, clients and matrix partners.
· Responsible for identifying resource need and obtaining appropriate funding/approvals.
· Responsible for selecting, developing, and deploying staff in the most effective manner to meet assigned objectives. Responsible for performance management, compensation decisions, rewarding and recognizing employees, and providing on-going, regular performance feedback.
· Strategic Partnership & Planning: Formulates highly complex, effective strategies consistent with the business and competitive strategy of the organization and/or functional area. Examines policy issues and strategic planning with a long-term as well as short term perspective. Determines objectives and sets priorities; anticipates potential threats or opportunities and vets them within the organization and with the client as appropriate. Develops strategies, objectives, and direction for both own direct reporting organization as well as client organization(s).
· Change Management & Innovation: Proactively engages client leaders and matrix partners to actualize change initiatives. Develops and/or encourages new ideas/approaches. Establishes procedures and practices which promote the adoption of appropriate solutions and sustainability of desired results in highly complex environments. Uses efficient and cost-effective approaches to integrate technology into the workplace and improve program effectiveness. Develops strategies using new technology to enhance decision making. Understands the impact of technological and process changes on the organization.
· Results & Accountability: Ensures that effective controls are developed and maintained to ensure the integrity of the organization. Takes corrective action, as appropriate. Ensures that performance is aligned with mission, goals and outcomes and is completed within established timeframes. Monitors and evaluates highly complex plans; focuses on results and measuring attainment of outcomes. Has budget accountability.
Basic Qualifications:
· Minimum five (5) years of management experience.
· Minimum ten (10) years of process and/or project management, consulting, or related business experience.
· Bachelor's degree OR four (4) years of experience in a directly related field.
· High School Diploma or General Education Development (GED) required.
License, Certification, Registration
· N/A

Additional Requirements:
· Must be able to work in a Labor/Management Partnership environment.

Preferred Qualifications:
· Knowledge of process management/improvement, methodologies preferred.
· Health plan management knowledge preferred.
· Graduate degree in a business or management discipline preferred.
Employee Status:
Yes, 5 % of the Time
Job Level:
Director/Senior Director
Job Type:
More Information About the Job
Is Relocation Available?
Yes, regional
Is there a bonus structure?
Are you open to sponsorship?
This position is:
Is there a possibility to work remote?
Is there equity?
Are there flexible work hours?
Does this position have direct reports?
Who does this position report to?
Executive Director, Pricing Systems & Data Services. Executive Director reports to the VP.
What are the 3-4 non-negotiable requirements on this position?
Must be a proven leader at a very high level within an organization. Experience with VP level audience and enterprise wide programs. Strong working Knowledge of the Healthcare, Medicaid space, Medicaid reporting
What are the nice-to-have skills?
What is exciting about this opportunity? Please use this section to describe team and company culture.
Very high visibility role working with leaders across a 65B organization. We proudly serve 11+ million members from 600+ locations in 8 states and D.C. Together, our more than 200,000 dedicated professionals work to advance Healthcare's commitment to delivering a healthier tomorrow. Driven by passion, we strive to take Healthcare to the next level.
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