Lead Ohio Department of Medicaid (ODM) contractual requirements, such Network Development Management Plan (NDMP), Network adequacy, Provider Engagement and Education
Oversee Provider’s operational strategy for Ohio
Ensure evaluation and outcomes and alignment across senior leaders to ensure Provider contracting, network and relations are measurable
Oversee collaboration with market and enterprise workgroups to ensure alignment and overall implementation of Ohio strategy
Represent Ohio Market Leadership as panelist and subject matter expert
Collaborate with the Ohio Executive team to ensure provider contracting and engagement performance
Build, maintain and improve all structure and processes necessary to assure impeccable regulatory record
Collaborate, innovate and support provider approaches to address contract compliance
Coordinate and collaborate with providers, local and state government, community-based organizations, ODM, and other ODM-contracted managed care entities
Develop health plan Network policies, procedures and goals as needed
Monitor health plan Network budgets; describe variance detail monthly with effective action plans
Produce team results that demonstrate engagement rates, low Grievances & Appeals, Continuous Improvement, Human Capital metrics

Bachelor of Science/Arts Degree or equivalent years of relevant work experience
Master’s degree in business or health care preferred
A minimum of ten (10) years of experience in health care external stakeholder and community program support, project and program management; complex business processes, strategic and business planning or related is required
A minimum of three (3) years of prior management experience is required
Proficient in Microsoft Excel, Word, PowerPoint and Excel
Critical listening and systematic thinking skills
Planning, problem identification and resolution skills
Business process/management skills
Strong financial background
Strong oral, written, and interpersonal communication skills
Excellent leadership, management and supervisory skills and experience
Energetic, enthusiastic, and politically astute
Ability to act with diplomacy and sensitivity to cultural diversity
Responsive to a changing environment
Strategic deployment and management skills
Knowledge of regulatory reporting and compliance requirements
Proficiency with provider engagement, performance improvement and operations

Associate Vice President – Provider Relations

Key skills