Leads operations for a Care Management Center (CMC), Health Plan, Program, or Product to ensure operational success and compliance in meeting clinical, quality, customer, business financial, and employee targets and objectives. May partner with account managers to achieve a high degree of customer service. Ensures cost effective approach to processes and deliverables for assigned business unit, program or product.

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  Manages financial performance, operating budget and variances from plan to ensure cost effective delivery of service. Responsible for development and implementation of annual operating budget.

  
  

  Oversees compliance to all operations performance standards. Develops and activates action plans to bring back in compliance when standards are not met.

  
  

  Responsible for developing and fulfilling service level agreement with Account Management.

  
  

  Creates and manages high-performing cross-functional, matrixed team, ensuring staff provide appropriate and efficient services. Continually monitors services and programs to ensure that client needs and contract obligations are being met in accordance with policies and procedures.

  
  

  Directs the delivery of high-quality services and ensures that quality management plans and protocols are implemented and that services are delivered in accordance with policies and procedures. Monitors quality assurance indicators and provides quality oversight.

  
  

  Manages high-risk cases and utilization trends. Provides required management reports to internal and external customers and clients.

  
  

  Coordinates network provider activities.

  
  
  
  

Other Job Requirements

Responsibilities

• 10+ years of broad based Health Care clinical and operational experience.


• 7+ years management level experience in the managed healthcare industry.


• Business and organization knowledge specific to managed healthcare principles, call center and clinical operations.


• Ability to achieve organizational goals through development of effective teams, through awareness of opinions, resolving conflicts and building collaboration among all levels of the organization.


• Strong written and verbal communication skills.


• Quantifiable business results, including understanding financial and quantitative information and has ability to manage operations within budgets.


• Ability to identify problems, recognize symptoms and causes and establish and implement solutions.


• Motivates and empowers others to attain personal and team goals.


• Demonstrates excellent negotiation and communication skills.


• Service oriented (External and Internal).


• Flexible and adaptable.

General Job Information

Title
VP General Manager - Public Market Behavioral Health

Grade
32

Work Experience
Management/Leadership, Operations

Education
Masters (Required)

License and Certifications - Required

License and Certifications - Preferred

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.