Chief Operating Officer -Medicaid

Become a part of our caring community and help us put health first
The Chief Operating Officer (COO) establishes long-range goals, objectives, and plans and monitors financial and operational performance. They will be responsible for the strategic development and oversight of operations for Humana's Virginia Medicaid Plan. They will manage ongoing operations across multiple levels of the organization to meet operational Contract requirements and financial performance goals. They will be accountable for operational results. The COO represents the plan externally and to Commonwealth and external agencies.

• Directs and coordinates day-to-day plan functions, including Reporting, Claims Administration, Encounter Data Quality, Grievance and Appeals, Information Technology and Systems, Member Services, Provider Services, and Business Continuity Planning and Emergency Coordination
• Liaise among DMAS, plan leadership, and corporate contacts responsible for the execution of Contract deliverables
• Works with the plan Chief Executive Officer to maintain important stakeholder relationships throughout Virginia
• Leads internal infrastructure to review and improve operational functions
• Manages implementation of strategic plans developed in cooperation with the Plan leaders
• Oversees development and maintenance of operational policies and procedures
• Effectively implements business plans and oversees audit processes
• Owns execution of daily operating objectives and goals, including key performance metrics
• Plans organizational growth and potential staff successions
• Develops and cultivates a diverse and inclusive environment
• Maintains intimate familiarity with Contractual requirements and stipulations
• Understands and actively manages ongoing adherence to local, Commonwealth, and federal regulatory and programmatic requirements
• Mitigates risks potentially impacting the Commonwealth of Virginia and the plan by proactively monitoring any risk factors and red flags that may arise during operations
• Communicates with DMAS and direct plan/corporate leadership regarding any necessary operational or regulatory changes
• Leads conflict resolution for any Provider relations or network issues that may occur

Use your skills to make an impact
Required Qualifications

• Bachelor's degree in Business, Operations Management, Healthcare Administration, or related field
• Minimum two years of experience in health plan management
• Minimum four years of experience working in healthcare operations
• Experience in strategic and thought leadership in supporting Medicaid health plans
• Leadership background with more than five direct reports

Preferred Qualifications

• Master's degree
• Candidates residing or willing to relocate to VA are preferred

Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay decisions will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$181,200 - $249,300 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of Humanato take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.