SVP COO Scott & White Health Plan

The Senior Vice President, Chief Operating Officer (COO), will serve as the executive leader for the Health Plan and be responsible for directing, administering and achieving goals and objectives established by the Chief Executive Officer.  This position is responsible for all operational areas in the Health Plan including, but not limited to, Member and Provider Services, Claims, Enrollment and Configuration, Clinical Systems, Project Management, & Information Systems oversight.  In the absence of the CEO, the COO has overall responsibility for all operations across the Health Plan.  

ESSENTIAL FUNCTIONS

• Provides leadership to the Health Plan operations for all lines of the business to achieve specific objectives.  
• Partners with multiple stakeholders and leadership to establish strategic visions, operational objectives and policies and procedures.  Assumes primary responsibility for the implementation of yearly rolling strategic plans.  Provides oversight of major corporate-wide projects and initiatives inclusive of process improvement, focused on operational efficiency as well as cultural transformation initiatives.
• Ensures that all organizational activities and operations are carried out in compliance with local, state, and federal regulations, standards and laws governing the operation.  Supports operating policies intended to mitigate risk; identifies and recommends any changes to the CEO as needed.  
• Provides expertise in mergers, acquisitions, joint ventures and other such efforts that will enhance the Health Plan�s position in a consolidating market.
• Actively participates in Board activities including planning, reporting, presenting and training.
• Responsible for the success of customer satisfaction strategies and objectives, assuring continual improvement of customer satisfaction ratings.  Develops strategies and criteria for superior customer communication and retention.  Develops and maintains external relationships with providers, employers and other organizations to ensure member retention, growth and service excellence.  Partners with key customers to provide excellent, metric driven accountability and timely problem resolution.  
• In partnership with CFO and CEO, reviews, revises, directs and manages departmental budgets for assigned areas.  Develops a broad-based organizational budgeting strategy incorporating both long and short-term corporate objectives.  Manages the annual operating plan execution process and drives improvement activities to achieve financial results across all lines of business.  Focuses on cost management initiatives and programs to improve financial performance.
• Responsible for long range and state-of-the-art information system plans, technologies and business applications to support business strategies and objectives.
• Collaborates with Human Resources to develop and complete an assessment of staff core competencies as part of an effort to attract, retain and develop top talent.  Develops an ongoing plan to fill skill gaps, including but not limited to, training, cross training, reassigning roles, employee engagement scores, etc., for personal development.  Establishes annual employee performance goals and developmental plans for all direct reports and their respective teams.  Monitors progress on quarterly basis ensuring that morale and productivity of employees is at the highest possible level.

KNOWLEDGE, SKILLS, & ABILITY

• Bachelor's degree in Business Administration, Healthcare Administration or related field of study.  Master's degree preferred.
• At least 8 years of management experience with a progressive track record in leadership positions in the health insurance industry.
• Project management experience and proven experience resolving business operations issues or leading initiatives to improve processes or enhance systems required.  
• Must have excellent problem-solving, decision-making skills and ability to establish strategic direction and provide operational direction to direct reports for tactical implementation.
• Exceptional knowledge of the Health Care Reform environment and understanding of current thinking on effective strategies for health plans.
• Experience working closely and effectively with physicians, hospitals and other healthcare providers with a preference for background that also includes integrated delivery systems experience.
• Experience in understanding a highly diverse, urban marketplace.
• Able to establish what metrics to use to run the business day to day.
• Demonstrated strong financial acumen as well as the ability to create and revise operational plans to execute with a strong focus on results.
• Demonstrated success leading all aspects of provider networks, including: network development, provider contract negotiations and relations and development of contracting strategies.
• Demonstrated success in leading IT and other business systems and processes.
• Demonstrated ability to develop and implement strategic plans in a clearly articulate manner and garners the support from the staff during the process.
• Demonstrated understanding of how data and drivers of medical cost trends can be incorporated into operations to mitigate trend.

MINIMUM QUALIFICATIONS

• 8 years of experience
• Bachelor's degree

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