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Humana Inc.
Tulsa, OK, United States
Posted on Apr 01, 2022 Apply for this job your email: upload resume: Profile Job Information Humana VP, Clinical Operations in Tulsa Oklahoma Description VP, Clinical Operations and Chief Clinical Officer of Kindred at Home, you will be responsible for planning and creating the ongoing strategic, operational, and service design to achieve
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Tulsa, OK, United States
Posted on Jun 14, 2021 Apply for this job your email: upload resume: Profile Description The Chief Medical Officer, Group Medicare relies on the medical background to create and oversee clinical strategy for the Group Medicare business. The CMO Group Medicare, requires and in-depth understanding of how organization capabilities interrelate acros
Job Source: Humana Inc.Trace3
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Vice President, Client Access About the Company Well-established organization providing evidence-based mental health & family services in the local community Industry Mental Health Care Type Non Profit Founded 1921 Employees 1001-5000 Categories Health Care Mental Health Addiction Treatment Non-Profit & Philanthropy Family Services Trauma Care Sup
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Tulsa, OK, United States
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Job Source: CommuniCare Health Services CorporateFamily & Children's Services
Tulsa, OK, United States
Assist FCS clients with applying, navigating, and understanding Oklahoma Medicaid benefits and its private Contracted Entity managed plans. Function as an agency Medicaid expert and liaison with clients and staff to maximize reimbursement. Determine client eligibility for Medicaid, Medicare, or other applicable insurance. Assist with Medicaid enro
Job Source: Family & Children's ServicesTulsa, OK, United States
Industry
Manager, Executive, Clevel, Operations, 100k
Posted on
Jun 07, 2023
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Job Information
Humana
Regional VP, Operations Medicaid
in
Tulsa
Oklahoma
Description
The Chief Operating Officer (COO) establishes long-range goals, objectives, and plans and monitors financial and operational performance. They will be responsible for the strategic development and oversight of operations for Humana's Oklahoma Medicaid Plan. They will manage ongoing operations across multiple levels of the organization to meet operational Contract requirements and financial performance goals. They will be accountable for operational results. The COO represents the Plan externally and to State and external agencies.
Responsibilities
Directs and coordinates day-to-day plan functions, including Reporting, Claims Administration, Encounter Data Quality, Grievance and Appeals, Information Technology and Systems, Enrollee Services, Provider Services, and Business Continuity Planning and Emergency Coordination
Liaise among OHCA, plan leadership, and corporate contacts responsible for the execution of Contract deliverables
Works with the plan Chief Executive Officer to maintain important stakeholder relationships throughout Oklahoma
Leads internal infrastructure to review and improve operational functions
Manages implementation of strategic plans developed in cooperation with the Plan leaders
Oversees development and maintenance of operational policies and procedures
Effectively implements business plans and oversees audit processes
Owns execution of daily operating objectives and goals, including key performance metrics
Plans organizational growth and potential staff successions
Develops and cultivates a diverse and inclusive environment
Maintains intimate familiarity with Contractual requirements and stipulations
Understands and actively manages ongoing adherence to local, State, and federal regulatory and programmatic requirements
Mitigates risks potentially impacting the State of Oklahoma and the plan by proactively monitoring any risk factors and red flags that may arise during operations
Communicates with OHCA and direct plan/corporate leadership regarding any necessary operational or regulatory changes
Leads conflict resolution for any Provider relations or network issues that may occur
Required Qualifications
Bachelor's degree in Business, Operations Management, Healthcare Administration or related field
Minimum two (2) years of experience in health plan management
Four (4) to six (6) years of experience working in healthcare operations
Leadership background with more than five (5) direct-reports
Preferred Qualifications
Master's degree
Experience in strategic and thought leadership in supporting Medicaid health plans
Additional Information
This role is based in Oklahoma City
Role is leveled as RVP, Operations
Scheduled Weekly Hours
40
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.
Humana Inc.
Website : http://www.humana.com
DescriptionHumana's Associate Vice President (AVP), Technology and Cybersecurity Risk works closely with all areas of Enterprise Information Protection (EIP), Internal Audit, Enterprise Risk Management, business units, regulator...
DescriptionHumana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health and well-being of the people we...
DescriptionHumana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health and well-being of the people we...
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Email Alert for Regional VP Operations Medicaid jobs in Tulsa, OK, United States
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