AVP, Health Plan Operations
Nevada

Summary
The AVP, Operations will report directly to the health plan CEO or COO with a dotted line to the SVP, Operations.  The incumbent will work to advance the health plan’s strategic imperatives as the primary link between the HO and health plan operations.   The incumbent will be responsible for health plan dashboards, operations policies, OPEX, best practices and regulatory compliance. The incumbent will build strong working relationships with plan senior management and HO support areas to assist in meeting the goals of the organization. In addition, the incumbent will demonstrate high levels of flexibility by managing projects at the health plan based on strategic priorities. The incumbent will be responsible for identifying and prioritizing health plan opportunities for improvement in the areas of efficiency and effectiveness.

Education and Experience
• Bachelor’s Degree or equivalent experience in Business, Health Care or related field; Master’s Degree preferred
• Minimum of eight years work related experience
• Project management or leadership experience in a medium to large size business environment.
• 3-5 years of demonstrated experience in data assimilation & analysis
• Experience with change management

Certification and Licensure
• Black belt quality certification a plus

Knowledge and Skills
• Excellent analytical, organizational, problem-solving, and communication skills
• Ability to demonstrate political sensitivity and to work effectively with senior level management as well as with multi-disciplinary teams across department lines
• Demonstrated leadership in healthcare operations including claim payment and root cause identification
• Strong leadership, coaching, and staff development skills
• Strong knowledge of data management and interpretation
• Conflict resolution/mediation experience
• Clinical or coding skills a plus
• Quality training a plus