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AVP, Health Plan Operations - New Mexico
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$122,430.44 - $238,739.34 a year
- This position plans, organizes, staffs, and coordinates the operations of state Medicaid/CHIP, Medicare and Marketplace Health Plan operations.
- Serves as the Senior Plan leader and liaison for MHI Service Operations, including: Claims, Configuration Information Management, Enrollment, Contact Center Operations, IT, Provider Configuration Management, Program Integrity, Risk Adjustment, Provider Resolution Team, Provider Appeal and Grievances, Member Appeals and Grievances, and other departments as required.
- These MHI shared services operations that support the Health Plan will have dotted line responsibility and accountability to this position.
- Proactively develops, tracks, and reports to Plan leadership MHI Service Operations performance relative to Plan compliance requirements, key performance targets and/or associated service level agreements.
- This role requires the identification and adoption of best practices from across the enterprise for Health Plan and MHI Service Operations; developing strategies and tactics in partnership with MHI Service Operations to mitigate any issues or performance levels not meeting established service levels and provides corporate oversight including the efficacy of vendor management.
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