This VP Case Manager Position position Purpose:
Oversee maternal/child care health plan programs, including TANF
and CHIP. Ensure all maternal/child programs are designed,
implemented, and operated within defined parameters.
o Oversee budgets, revenue targets and P&L related activities
for all maternal/child programs
o Lead strategies for product development and implementation for
all maternal/child programs
o Guide overall performance of health plan as an integral part of
the health plan leadership
o Lead and support medical management programs and processes to
meet health plan and state goals
o Lead and support network plan including contracting and provider
relations for providers to meet health plan and state goals
o Direct the development and implementation of policies &
procedures, work processes, financial reporting, compliance,
systems, ensuring metrics are established and measured
o Ensure the corporation's strategic objectives are maintained at
the health plan, and all organizational, state, compliance and
contractual agreement requirements are met
o Develop and maintain key state and federal relationships,
coordinate and participate on departmental and state committees,
and other activities, meetings and trainings
o Participate in the integration of specialty products in
Bachelor's degree in Social Work, Health care Administration,
Business Administration or related field. 10+ years of managed
health care operations, administration and management experience.
Knowledge of case management practices, managed care, Medicaid and
CHIP populations preferred. RN preferred.
Strongest need is for someone who has had experience in managing
programs for pregnancy - high risk, NICU, and secondary more
routine pediatric cases - not the complex or medically fragile.
They will be under the complex VP. Managed care experience is
really essential. If they were a Director in another Medicaid plan.
Or if have had experience in a senior leadership role in a Healthy
Start program and worked with a managed care plan that would be a
We are an equal employment opportunity employer and will consider
all qualified candidates without regard to disability or protected