Chief Operating Officer

Minimum Education
Bachelor's Degree (Required)
Master's Degree advanced degree (Preferred)

Minimum Work Experience
8 years years of experience in managed care. (Required)
3 years years in managed care administration. (Required)

Job Functions
Essential job duties:

• Oversight of the operational functions in the Health Plan which could include Administrative Support, Claims, Provider Relations, and Information Technology as appropriate based on Plan design.

• Serves as Plan liaison to Shared Services support functions as well as providers and regulators as needed.

• Provides input on overall strategic direction of Health Plan and assist in developing policy and programs to achieve business results.

• Ensures a strong connection and working knowledge of current status with local network development, provider relations, regulatory and contractual compliance.

• Hires, trains, coaches, counsels, and evaluates performance of direct reports.

• Develop, execute and maintain a provider network strategy, business plans, and goals.

• Collaborates with the Plan management team and others to develop and implement action plans for the operational infrastructure of systems, processes, and personnel designed to accommodate the growth objectives of the organization.

• Assist CEO with aspects of local and state government relationships, including dealing with regulators as necessary to establish and continue effective working relationships.

Other job duties:

• May perform other duties in addition to those outlined in this job description.

Organizational Accountabilities
Organizational Accountabilities (Managers)
Leadership Excellence

• Demonstrates understanding of quality of service and collaborates with co-workers to ensure excellence is achieved

• Innovates through improvement of care and/or efficiency of operational processes.

• Dedicated to a standard of performance excellence and high quality

Collaboration

Leadership Skills

Supervisory Responsibilities

• The incumbent will be responsible for the general direction of staff member(s).

Blood Borne Pathogen Exposure

• Category II: Job may expose incumbent occasionally or in emergency situations to blood, body fluids, non-intact skin or tissue specimens.

Protected Health Information Access Level

• Level IV - Full Access Incumbents in this job may access any protected health information associated to a customer's needs, the service(s) rendered and the position's functions.

Working Environment

• This job operates in an office environment.

Physical Requirements

• Sedentary Work: Lifting 10 lbs. maximum and occasionally lifting and/or carrying such articles as dockets, ledgers and small tools. Although a sedentary job is defined as one that involves sitting, a certain amount of walking and standing is often necessary in carrying out job duties. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Travel Requirements

• None

DC RESIDENTS ENCOURAGED TO APPLY