Director of GBD (Government Business Division) Operations

Iselin, NJ

Type: Full Time

Eve Crane & Associates Inc.

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Responsible for the fiscal and operational management/implementation and oversight of a special products and programs. Primary duties may include, but are not limited to:

·Develops and implements the strategic vision, goals, objectives, policies and decision making for the special product/program organization.

·Oversees all health plan medical management programs including concurrent review, pre-certification, discharge planning, case management, disease management, provider profiling, quality management, accreditation, health promotion and outreach.

·Facilitates and collaborates with medical management staff to identify gaps and improve processes.

·Oversees the design and development of provider contracts and partnerships to achieve quality, cost management, and strategic business development objectives; develops and negotiates strategic provider contracts on behalf of the Plan.


Requires a BA/BS; 10+ years of relevant experience, including
 prior management experience in a managed care setting with:

Will have P&L responsibilities.
Leads the performance management/earnings improvement activities for the special product/program organization.

Hires, trains, coaches, counsels, and evaluates performance of direct reports.

Oversees a large staff both internally and field-based staff
MPA, MPH, MSN or MBA with Health Care concentration preferred.

Company is an equal opportunity employer that is committed to diversity and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
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