Department: 500804 Other Administration
Facility: Hometown Health
Reno, NV
Schedule: Full Time - Eligible for Benefits
Shift: Day
Hours:
Job Details:
  • Position Purpose:

    Position is accountable for strategy development and deployment, ongoing operational compliance and consistent technical delivery of operational results for each of the operational areas reporting to this position.  In addition, this position will assure proper planning and workflows affecting performance to and from matrix departments where dependency may be present.  Position is also accountable for budget planning and adherence to exceeding the thresholds established by the Health System and approved by the Board of Directors.

     

    Overall results attained should be consistent with the Health Plan and Health System objectives to achieve excellence in service operations that affect member growth and retention, market-leading operational metrics, compliance with all local, state, and federal standards, as well as assure efficient market-leading provider network access and unit cost, and cost-effective operations.

     

    Position background to include commercial and government programs, strong operations experience in managed care/insurance operations including fully-insured, self-funded, and government product lines.  Throughout, leader will be responsible to assure product compliance with applicable laws and/or regulations across all products offered by Health Plan and self funded administrator.

    Nature and Scope:

    Position will report to the Vice President of Hometown Health Plan with ongoing interaction with intra-plan departments as well as Integrated Health Network matrix partners.

     

    Regular interactions expected with providers, members, employers, employees, auditors and regulators as necessary.

     

    This position shall provide leadership, planning and ongoing management through reporting relationships to assure excellence in operations and work products generated through the Health Plan and related affiliates.

     

    Position is charged with recruitment and retention of capable staff and successful talent base to execute strategy and operations plan.

     

    This position is a key functional leader within the Health Plan and has the authority and accountability to lead the operational areas assigned to next-level capabilities and operational efficiencies.

     

    Position will anticipate the continuity of employer, member and provider best practices within its operational oversight. In addition, the position will continuously improve, communicate and leverage the value proposition of the Health Plan to increase the likelihood of existing and new clients choosing Hometown Health/Renown Health over competitors.

     

    Position will navigate strategic and operational challenges within a dynamic industry and balance achieving set accountabilities with constraints of limited resources.

     

    This position does not provide patient care.  

    The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.

    Minimum Qualifications:  Requirements - Required and/or Preferred

    Education:

    Must have working-level knowledge of the English language, including reading, writing and speaking English. Bachelors Degree in Business required and Masters Degree in Business or Healthcare Administration is strongly preferred. 

    Experience:

    Minimum six years in health plan operations related to the areas of direct responsibility of this position description.  Experience preferably based in healthcare, managed care, or insurance environment.

    License(s):

     

    Certification(s):

    None.

    Computer / Typing:

    Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.



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