Job Title

Vice President, CareOregon Metro

Exemption Status

Exempt

Management Level

Vice President

Direct Reports

Metro Integration Team

Manager Title

Chief Medicaid Programs Officer

Department

CareOregon Metro

Pay and Benefits

Estimated hiring range $225,000 - $275,000 /year, 15% bonus target, full benefits. www.careoregon.org/about-us/careers/benefits.

Posting Notes

This is a hybrid role that will require you to go into the downtown Portland office 1 day a week. You need to be local to the Portland area to apply.

Job Summary

This position is responsible for leadership and implementation oversight of the Metro Medicaid business strategy and goals in conjunction with the Chief Medicaid Programs Officer. Primary duties include strategic planning and operational effectiveness, as well as development and oversight of resources, relationships, and successful teams. Work involves strong relationship building, governance, conflict resolution and communication throughout the enterprise. This position actively and regularly participates in strategic planning and collaboration.

Essential Responsibilities

Strategic/Operational Leadership

• Ensures CareOregon’s Metro Medicaid initiatives are implemented in alignment with both CareOregon and Health Share of Oregon’s vision and strategic plans.

• Participates in Health Share committees to effectively represent CareOregon and build and maintain collaborative, mutually beneficial, relationships.

• Establishes and effectively executes both short-term and long-term operational strategies to achieve CareOregon Metro’s goals, in alignment with CareOregon strategic goals.

• Leads and supports the operational execution of the CareOregon Metro Medicaid Line of Business goals, ensuring the organizational cost, quality, access, and operational targets are met or exceeded.

• Develops and leads a model for operations and infrastructure, ensuring understanding and alignment across intersecting departments, matrixed relationships, and external partners.

• Partners with operational, financial, and other CareOregon leadership to ensure internal systems and measures are in place to enhance effective, efficient, and compliant operations.

• Provides input on benefit strategy based on identified network needs and facilitates execution of the benefit design and strategy developed by the respective benefits.

• Works with Quality, Informatics and Evaluation staff to identify meaningful performance metrics; ensures the timely and accurate monitoring and reporting of performance against metrics.

• Engages the organization in continuous quality improvement to achieve high level of stakeholder satisfaction.

• Through proactive leadership, assures excellent service to members and providers so that high levels of satisfaction are achieved.

• Serves as a sponsor for key projects and initiatives.

  Strategic Planning

• Leads the development of vision and goals for the CareOregon Metro team in conjunction with the Chief Medicaid Programs Officer.

• Partners in developing and refining strategic and tactical plans in alignment with organizational vision and goals.

• Defines operational structure for areas of oversight and approves policies.

• Participates in the strategic planning process for the organization.

• Maintains an enterprise view while establishing business unit priorities.

  Financial/Resource Management

• Develops budgets in alignment with strategic planning and organizational priorities.

• Ensures teams have sufficient resources to perform their work.

• Ensures budgets are monitored and managed effectively across areas of oversight.

• Approves resource allocations within budget, including people, finances, and timelines; make decisions on exceptions.

  Relationship Management

• Forges strong relationships with key stakeholders throughout the organization.

• Ensures strategic messages are regularly and effectively relayed to management team and staff; promotes transparency.

• Develops strategic partnerships with health system, safety net, and community-based services to ensure CareOregon priority goals are met.

• Leverages current relationships and forges and leverages new relationships with community partners, provider networks, and other constituents in alignment with organizational direction and priorities.

• Collaborates with leaders across the organization in identifying integrated improvement strategies and ensuring meaningful integration.

• Represents the organization in external meetings and functions, providing strong leadership presence and effectiveness.

  Employee Supervision

• Directs team(s) and establishes team direction and goals in alignment with the organizational mission, vision, and values.

• Identifies work and staffing models; recruits, hires, and oversees a team to meet work needs, using an equity, diversity, and inclusion lens.

• Identifies department priorities; ensures employees have information and resources to meet job expectations.

• Leads the development, communication, and oversight of team and individual goals; ensures goals, expectations, and standards are clearly understood by staff.

• Manages, coaches, motivates, and guides employees; promotes employee development.

• Incorporates guidance from CareOregon equity tools into people leadership, planning, operations, evaluation, budgeting, resource allocation, and decision making.

• Ensures team adheres to department and organizational standards, policies, and procedures.

• Evaluates employee performance and provides regular feedback to support success; recognizes strong performance and addresses performance gaps and accountability (corrective action).

• Performs supervisory tasks in collaboration with Human Resources as needed.

  Organizational Responsibilities

• Perform work in alignment with the organization’s mission, vision and values.

• Support the organization’s commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals.

• Strive to meet annual business goals in support of the organization’s strategic goals.

• Adhere to the organization’s policies, procedures and other relevant compliance needs.

• Perform other duties as needed.

  Experience and/or Education

  Required

• Minimum 10 years’ experience in developing, managing, or influencing managed care, health care, or related programs required

  Preferred

• Strong preference for prior experience with Medicaid programs

• Experience requiring knowledge of regulations and statutes pertaining to Medicaid and Medicare

• Experience working in highly matrixed organization and with external partners in complex collaborative structures or organizations

• Minimum 5 years’ experience in a supervisory position

• Master’s or Bachelor’s degree in health policy, public health, health care administration, business administration, law, or related field helpful

  Knowledge, Skills and Abilities Required

  Knowledge

• Applied knowledge of state and federal managed care program requirements, including Oregon Health Plan health care laws and regulations

• Ability to obtain and retain knowledge of:

• government regulations as they relate to the administration of the Medicaid program;

• the principles and practices of managed care and Coordinated Care Organizations;

• plan benefits, the Prioritized List, systems and procedures, changes in Medicaid guidelines and regulations, changes in the health care services, changes in the legal/legislative arena that impact operations; and

• health care public policy issues

• Understanding of the nature of governance; board obligations, responsibilities, roles and duties; governance/director of best practices

• Understanding of healthcare industry structure/dynamics

• Knowledge of best practices that drive an environment of continuous improvement

  Skills and Abilities

• Highly collaborative, cross-functional, and systematic

• High degree of diplomacy, credibility, and persuasiveness to consistently cultivate effective working relationships; ability to effectively express ideas and gain acceptance

• Ability to build and strengthens relationships and a culture of trust

• Comprehensive program planning and development, management, and evaluation skills

• Ability to manage multiple priorities and coordinate work across multiple systems

• Highly effective written and verbal communication skills, as well as strong presentation skills

• Ability to negotiate favorable outcomes and build consensus

• Highly effective strategic planning and resource/budget management skills

• Leadership effectiveness and ability to design and implement constructive change

• Possess a high degree of initiative and motivation along with the ability to effectively collaborate and plan with departmental leadership and staff, and other stakeholders/customers

• Ability to work effectively with diverse individuals and groups

• Ability to learn, focus, understand, and evaluate information and determine appropriate actions

• Ability to accept direction and feedback, as well as tolerate and manage stress

• Ability to see, read, and hear for at least 6 hours/day

• Ability to speak clearly and perform repetitive finger and wrist movement for at least 3-6 hours/day

  Working Conditions

  Work Environment(s): ☒ Indoor/Office ☐ Community ☐ Facilities/Security ☐ Outdoor Exposure

  Member/Patient Facing: ☒ No ☐ Telephonic ☐ In Person

  Hazards: May include, but not limited to, physical and ergonomic hazards.

  Equipment: General office equipment

  Travel: May include occasional required or optional travel outside of the workplace; the employee’s personal vehicle, local transit or other means of transportation may be used.

  #Li-Hybrid

  Candidates of color are strongly encouraged to apply. CareOregon is committed to building a linguistically and culturally diverse and inclusive work environment.

  Veterans are strongly encouraged to apply.

  We are an equal opportunity employer. CareOregon considers all candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, or veteran status.

  Visa sponsorship is not available at this time.