Chief Administrative Officer, Health Plan Services - Health Plan Services

Cook County Health

Full-time - Senior

Hospitals

About the position

The Chief Administrative Officer, Health Plan Services (CAO, HPS) is a pivotal leadership role within Cook County Health (CCH), tasked with overseeing a health plan in a rapidly evolving healthcare landscape characterized by significant reform and competition. This position is responsible for the comprehensive administration of programs and services offered by the managed care health plan, ensuring that all managed care products align with the strategic goals and objectives of CCH. The CAO, HPS plays a crucial role in ensuring that the managed care services reflect the mission, vision, and core values of CCH throughout the community, while also maintaining high standards for the quality of medical service delivery. In this role, the CAO, HPS collaborates closely with health system leadership and medical staff, including contracted providers, to shape the strategic direction and major policies of CCH managed care. The CAO, HPS is responsible for the daily operations of CountyCare and its contractors, serving as the CEO of CountyCare. This includes ensuring operational efficiency and high-quality care within the managed care plan, while also overseeing the fiscal operations to promote cost-effective service delivery. Compliance with regulatory agencies and accrediting bodies is a critical aspect of this role, as is the commitment to improving community health and addressing societal issues that contribute to poor health outcomes. The CAO, HPS is also tasked with establishing and nurturing relationships with healthcare financing entities such as Medicaid and Medicare, ensuring that the health system meets the needs of the community while achieving financial viability. This position requires a proactive approach to problem-solving and the ability to foster a smoothly functioning organization by anticipating challenges and resolving disruptions in a timely manner. The CAO, HPS must conduct all responsibilities in alignment with the established ideals and policies of the health system, adhering to the ethical standards of health plan administration.

Responsibilities

• Lead the overall administration of programs and services provided by the managed care health plan.
• Ensure alignment of managed care products and services with CCH strategic plan goals and objectives.
• Oversee the quality of medical service delivery to meet or exceed standards.
• Participate in collective bargaining negotiations and consult with Labor Relations to generate management proposals.
• Document, recommend, and effectuate discipline at all levels within the organization.
• Direct and effectuate CCH management policies and practices.
• Develop CCH system policies and procedures in collaboration with health system leadership.
• Manage day-to-day operations of CountyCare and its contractors, serving as the CountyCare CEO.
• Ensure compliance with regulatory agencies and accrediting bodies.
• Establish and develop relationships with healthcare financing entities such as Medicaid and Medicare.
• Promote services produced in a cost-effective manner while ensuring fiscal operation of CCH managed care.
• Ensure accountability for improving community health status and addressing societal issues.
• Conduct operations consistent with established ideals, standards, and policies of the health system.

Requirements

• Bachelor's degree in a relevant field.
• Minimum ten (10) years of progressively responsible experience in the healthcare industry.
• Minimum of seven (7) years' experience in a senior leadership role within a health plan serving low-income and/or Medicaid clients.
• Minimum five (5) years' experience in a multi-faceted, multi-service provider setting.
• Prior experience establishing relationships with healthcare financing entities such as Medicaid and Medicare.