The Chief Operating Officer (COO) is an Enterprise Leader that provides leadership and strategic direction for operating units at BMCHP/WS (“BMCHP”), including the Customer Care Center, Claims, Enrollment, Operational Improvement, Network Management, Provider Operations, and Sales & Marketing. The COO will partner with BMCHP’s President, BMCHP executive leaders, and Boston Medical Center leadership to develop strategies that shape BMCHP’s overall direction, achieve the organization’s performance goals, and deliver outstanding value for BMCHP’s customers which include MassHealth and NH DHHS, our contracted providers, and our members.
The COO is a leader and innovator of new ideas, ventures and progressive initiatives and will consider the best interests and strategic direction of the entire organization when evaluating department decisions. Enterprise leaders will use their influence to work collaboratively across the organization to initiate and maintain relationships and resolve conflicts. Enterprise leaders will be comfortable dealing with ambiguity, uncertainty, complexity and time pressures, while leveraging these relationships.
Provides operational oversight for the multi-state health plan, and creates mechanisms to monitor infrastructure, processes and standards to achieve desired outcomes as part of corporate business plan and strategic initiatives.
Collaborates with Leadership to set goals, clearly define operations, and develop appropriate performance standards, metrics and reporting tools.
Develops, implements and manages the operations budget ensuring effective stewardship of resources, and achievement of Strategic Operating Plan (SOP) goals and annual corporate goals.
Sets vision and leads operational departments by directing and coordinating activities consistent with established goals, compliance and quality requirements, objectives and policies and procedures.
Develops short and long term strategies and tactics to assure operational and programmatic excellence, management and control.
Develops and implements strategies to deliver superior Customer Service, Enrollment and Claims Administration to members and providers.
Initiates, implements and monitors improvement activities aimed at reducing costs, increasing accuracy and efficiency and both internal and external customer satisfaction in each operational area.
Directs the organization’s sales and marketing strategies to drive membership growth and retention, and to align member- and provider- facing activities interactions with organizational goals.
Oversees the company’s network initiatives to ensure that contracting practices drive health outcomes, innovation and cost savings and support the company’s business lines including MassHealth ACO, MassHealth MCO, Massachusetts Qualified Health Plans (QHPs), New Hampshire Medicaid, and Massachusetts Senior Care Options (SCO).
Performs other duties and/or responsibilities as assigned.
Responsible for chairing Business Continuity Planning (BCP)/Emergency Preparedness efforts within BMCHP.
Develop and implement strategies to mentor, motivate and retain key employees, and to drive a culture based on data-based decision-making, performance, and operational efficiency.
Oversee diverse functional staff groups consisting of 100-150 employees in Operations.
Executive oversight of cross functional groups for major on-going strategic initiatives.
About our Ideal Candidate:
15+ years of senior management experience, with a minimum of 5 years leading one or more of the following functions: Customer Service, Claims, Enrollment, Operational Improvement, Value-Based Contracting, or Sales & Marketing
15+ years of experience in a managed care/health care environment or a related government program
Experience with government programs and their regulations, guidelines, and standards
Bachelor’s degree required. MBA, MPH or related post-graduate degree preferred.
Exceptional executive leadership, strategic and day-to-day project and task management
Internal Number: 2013640
About BMC HealthNet Plan
BMC HealthNet Plan is a non-profit managed care organizations committed to providing the highest quality healthcare coverage to underserved populations. In Massachusetts, BMC HealthNet Plan is the business name for Boston Medical Center Health Plan, Inc.; outside Massachusetts, Well Sense Health Plan is the business name.
BMC HealthNet Plan serves Massachusetts residents across four product lines: MassHealth (Medicaid), ConnectorCare, Qualified Health Plans, and Senior Care Options. We are one of the largest Medicaid health plans and the lowest cost Qualified Health Plan in 6 out of 7 regions* in Massachusetts.