Provide leadership, strategic direction, budget, and performance oversight of the organization’s Member benefits platform.
Serve as an organizational leader, driving transformation through the delivery of a comprehensive member benefit platform, ensuring alignment across markets and products.
Support market and product leaders to identify and develop effective benefits that best serve CareSource Members and mission.
Manage an elite team to oversee, interpret, and recommend best approach strategies to managing benefits and prior authorization.
Collaborate with finance to ensure appropriateness of benefits in support of actuarial analyses.
Maximize the use of business intelligence tools that support analysis and reporting of population health outcomes to drive improved benefits.
Collaborate with Medical Directors to ensure alignment of benefits, policies, and prior authorizations.
Responsible for the governance model to manage member benefits.
Provide leadership and direction to staff to ensure tasks, goals and strategies are successfully achieved.
Accountable for management of staff, infrastructure, budget, performance, and service levels.
Perform any other job related instructions, as requested.
Bachelor’s degree in business, finance, health care administration, or related field or equivalent years of relevant work experience is required
Advanced degree is preferred
A minimum of eight (8) years of managerial experience in health care with strong background in financial and health outcomes is required
A minimum of three (3) years of experience in managed care setting is preferred
Research, data analysis and trending knowledge is required
Proficient in BI tools (SQL, Microsoft, etc)
Staffing and forecasting experience
Proficient in Microsoft Office Suite to include Word, Excel and PowerPoint
Excellent written and verbal communication skills
Ability to develop, prioritize and accomplish goals
Ability to work independently and within a team environment
Attention to detail
Effective listening and critical thinking skills
Strong interpersonal skills and high level of professionalism
Effective problem solving skills with attention to detail
Registered Nurse (RN) is preferred
Internal Number: 19-0822
CareSource is a leading non-profit managed care company based in Dayton, Ohio. CareSource has been meeting the needs of health care consumers for more than 25 years.
To make a lasting difference in our members’ lives by improving their health and well-being.
At CareSource, our mission is one we take to heart. In fact, we call our mission our “heartbeat.” It is the essence of our company, and our unwavering dedication to it is a hallmark of our success.
Transforming lives through innovative health and life services.