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SVP Operations, Sentara Health Plan

Company: Sentara Healthcare
Location: Virginia Beach
Posted on: January 11, 2019

Job Description:

Overview:Sentara Health Care's Health Plan (Optima Health) is recruiting for a SVP, Operations. This position is based out of Hampton Roads, Virginia and reports directly to Optima--------s CEO. As the Senior Operations Executive, the role will be focused on building the right technical solution, creating strong metrics/analytics, developing plans to promote scalability to ensure Optima is delivering operational excellence in support of the strategic plan. The position provides direction, leadership, and management to the Operations team. The SVP is responsible for delivering excellent service, fulfilling and driving strong financial commitments and building a culture that is consistent with the values of Sentara and Optima. This position will have full responsibility for service delivery, member satisfaction, productivity, employee engagement, and other associated responsibilities. Responsibilities:This position is based out of Hampton Roads, Virginia and reports directly to Optima--------s CEO. As the Senior Operations Executive, the role will be focused on building the right technical solution, creating strong metrics/analytics, developing plans to promote scalability to ensure Optima is delivering operational excellence in support of the strategic plan. The position provides direction, leadership, and management to the Operations team. The SVP is responsible for delivering excellent service, fulfilling and driving strong financial commitments and building a culture that is consistent with the values of Sentara and Optima. This position will have full responsibility for service delivery, member satisfaction, productivity, employee engagement, and other associated responsibilities.Responsibilities:

    Overall accountability for managing multiple call centers, the performance of several on and offshore vendors, the Utilization Management Intake request process, and provider issue resolution.Drive change and innovation in a call center environment and have an outside-in perspective (is customer/provider driven; understands external trends and technological innovations)Accountable for Optima plan operations to include claims, enrollment, sales operations, business integration and call center operations. Must be creative and able to develop new product launches, and operating system design to support growth, retention and profitability of the health plan. Responsible for accurate claims adjudication and payment processes.Lead the development and implementation of another operating center to assist as a back up to Optima--------s VA and NC centers. Provide leadership over performance/earnings improvement activities. Collaborates on policy and program development to achieve business results through effective operations and financial management. Collaborate with various business unit leaders and key external partners. Qualifications:Education LevelMaster's Level DegreeExperience------- Successful leadership and experience working towards continuous process improvement. Focused on staff development for current and future roles. ------- Senior leadership experience managing across multi-site operations.------- Several years of senior level experience in successfully managing a busy call center. ------- Senior level experience working with medical claims. ------- Senior level operational experience with Commercial and Government programs------- Consistent record of accomplishments and the capability/flexibility to operate effectively leading change as well as effectively managing change.------- Adaptability and Flexibility: Must thrive well in a fast-paced environment.------- Strong Communication Skills: Transparency and an open communication style will be important. He/she must be accessible and deemed approachable by employees and various business unit leads.LicenseNone, unless noted in the "Other" section belowSkills------- Health Plan Operations - 10 years------- Executive -----" 5 years------- Management -----" 10 years

    Keywords: Sentara Healthcare, Virginia Beach , SVP Operations, Sentara Health Plan, Healthcare , Virginia Beach, Virginia

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