Director, Health Plan Operations (Must reside in Florida)

JOB DESCRIPTION Job Summary Leads and directs team responsible for the development and administration of state health plan operational functions, programs and services - ensuring functional operations, contractual compliance, and alignment with health plan member satisfaction, retention, quality, and financial goals. Must be able to work remote in Florida. Essential Job Duties • Under the direction of senior leadership, organizes, plans, staffs, and coordinates health plan operations for market-specific designated lines of business (Medicaid, Marketplace). • Collaborates with staff and senior leadership to develop and implement provider and member service strategies to improve access and satisfaction for designated health plan(s). • In conjunction with senior leadership, liaises with corporate operations functions including: claims, configuration information management, provider data management, credentialing, enrollment, and support center operations. • Oversees claims op...