SixSigma SoftSolutions

Atlanta, GA, 30309, USA

Tracking Code 304196-763 Job Description The primary accountability of this position is to provide the operational leadership required to achieve the quality and financial performance goals for Select Networks of Texas, LLC (Select).  The Executive Director has the “P&L” level responsibility for the product and the direct management responsibility for network design and compliance, contracting with product-wide medical and administrative services, quality management and compliance, quality improvement, financial and performance reporting and network relations.  Of highest importance, the Executive Director must maintain strong IPA performance and compliance such that strategic goals are routinely achieved. Required Skills * Develop and maintain strategic and annual business plans that can achieve agreed to quality and financial performance objectives. * Develop and maintain key medical and administrative contracts needed to achieve objectives.  Negotiate and maintain product-wide medical provider contracts with financial and other terms that are at least as competitive as those of similar organizations. * Provide the appropriate level of oversight to insure compliance with all HCFA and TDI regulations governing the PSO products. * Achieve and maintain very strong business relations with providers of contracted administrative services, medical care providers and organizations, regulators and other key customer groups. * Design and execute revenue and member growth strategies. * Maintain a highly effective quality compliance program covering all areas required to meet internal organizational objectives and to achieve compliance with HEDIS, NCQA HCFA and other regulatory requirements. * Achieve significant competitive advantage by recruiting, developing and supporting outstanding administrative and medical staff for the Select PSO organization.                                                                         Required Experience * Minimum seven years experience in managing health plans, IPAs, or other directly related managed care organizations. * Minimum five years experience in successfully meeting HCFA and TDI regulatory requirements. * A clear track record of executive leadership in growing an organization, achieving quality and financial performance objectives, designing and implementing strategic initiatives and building outstanding working relationships with physicians. * Masters degree in business administration, health care administration, finance or other related area is preferred. Key personal attributes include:
strong desire to lead and be at-risk for performance, ability to inspire others to achieve outstanding results, willingness to set priorities and maintain strategic focus, maintain the highest standards of integrity and business ethics and a passion for personal and team success Job Location Atlanta, GA, US. Position Type Full-Time/Regular

Supercharged
Job Search

Reach 1000's of hiring recruiters

• Create & Distribute Professional Resumes
• Get Googled by Thousands of Recruiters
• For Professionals earning more than $45K