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Executive Director, RiverLink Health
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Executive Director, RiverLink Health

Job Description

Job Summary:

The Executive Director, RiverLink Health, isresponsible for overseeing the operations and management of the local RiverLinkHealth office. The Executive Director will have direct oversight responsibility for the local operations concerning sales, provider relations, customer service and medical management.  The Executive Director ensures that the national methodology and organizational model is successfully implemented and operating at the local plan level. This positionwill also be responsible for financial performance and growth of the healthplan with a strong emphasis on STAR ratings. The Executive Director will play akey role in physician engagement and relationship building for the health plan. Accountabilities include supporting National  strategy and marketing objectives, CollabHealth Plan operations and service requirements andenterprise strategic payer and product initiatives.


Essential Duties:

  • Member of the CollabHealth Plan Services team
  • Responsible for compliance with applicable CMS regulations and successful operations of the health plan functions
  • Engages stakeholders as appropriate to ensure customer satisfaction
  • Stays current with managed care and health plan regulatory issues in relation to health program benefits, payer activity, products and delivery channels including health insurance exchanges,market competition, etc
  • Coordinates the implementation of national strategic processes
  • Develops and maintains strong working relationships with functional area counterparts,and ensures coordination and collaboration across the system
  • Coordinates the institution of best practice sharing, internal and external stakeholder validation of the effectiveness of health plan functions and processes
  • Focuses on STAR ratings and efforts that can be taken to positively impact the healthplan’s rating
  • Ability to evaluate financial data, reports, and trends at business unit and product level. Sees the big picture as relates to generating competitive financial results based on contextual factual information

This position is responsible for overseeing the day to day operations ofthe health plan. This position will work closely with the Medical Director toensure alignment across all market facing functions to obtain best in classservice to both members and providers.Key success indicatorsof this role:

  • Establish collaborative relationships with the provider network and key stakeholders
  • Achieve predefined sales goals through the annual AEP season
  • Achieve a 4 STAR rating after the first year of operations
  • Work collaboratively with National Leadership Team to ensure national processes and policies & procedures are implemented successfully
  • Identify,document and translate emerging successes and lessons learned to be shared across all health plans
  • Lead and support growth efforts in the health plan from a member, geographical andproduct prospective
  • Actively contribute to related efforts led by Nationaland other Regional/Division health system partners across CHI as appropriate

Job Requirements

Education:

  • Bachelor degree required; Masters in business, healthcare administration, or related field is preferred

Experience:

  • Ten years progressive managerial and strategic leadership experience in multi-regional and/or national health plan organizations, with a strong emphasis on Managed Government programs including Medicare Advantage
  • Five years strategic healthcare operations leadership, including sales, customer service and provider relations in support of market entrance opportunities and ongoing operations
  • Demonstrated success in leading multi-functional teams
  • Demonstrated relationship development and management profile, able to build relationship credibility and trust. Strong reputation for integrity and a partnering mindset.
  • Demonstrated ability to work effectively in a matrix-oriented organization
  • Demonstrated ability to effectively drive market growth strategy 
  • License/Certification:

    •  None

    Additional Responsibilities:

    • Demonstrates a commitment to service, organization values and professionalism through appropriate conduct and demeanor at all times
    • Adheres to and exhibits our core values:
      Reverence: Having a profound spirit of awe and respect for all creation, shaping relationships to self, to one another and to God and acknowledging that we hold in trust all that has been given to us.
      Integrity: Moral wholeness, soundness, uprightness, honesty and sincerity as a basis of trustworthiness.
      Compassion: Feeling with others, being one with others in their sorrows and joys, rooted in the sense of solidarity as members of the human community.
      Excellence: Outstanding achievement, merit, virtue; continually surpassing standards to achieve/maintain quality.
    • Maintains confidentiality and protects sensitive data at all times
    • Adheres to organizational and department specific safety standards and guidelines
    • Works collaboratively and supports efforts of team members
    • Demonstrates exceptional customer service and interacts effectively with physicians, patients, residents, visitors, staff and the broader health care community
    Catholic Health Initiatives and its organizations are Equal Opportunity Employers \\CB




  • Shift:  Day

  • Scheduled Hours per 2-week Pay Period:  80

  • Weekends Required:  None

  • Status:  Full Time
  • Job Snapshot

    Employment Type Full-Time
    Job Type Management
    Education 4 Year Degree
    Experience Not Specified
    Manages Others Not Specified
    Industry Healthcare - Health Services
    Required Travel Not Specified
    Job ID 1400018014
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    Executive Director, RiverLink Health


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