RVP GBD Programs

Tampa, FL

Type: Full Time

Eve Crane & Associates Inc.

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				Locations: Miami or Tampa, Florida

RVP- GBD Special Programs LTC_HIV

Medicaid Experience
 
Responsible for the fiscal and operational management/implementation and oversight of two Special programs, the Long term Care and HIV/Aids Program. This role reports to the Health Plan President and will be the senior most special program leader in the highest revenue and most complex markets where the program is subject to enhanced regulatory oversight, more stringent quality assessment, specialized contract negotiations and/or complicating geographic/market concerns. Primary duties may include, but are not limited to:

*Develops and implements the strategic vision, goals, objectives, policies and decision making for the Long Term Care and HIV/AIDS program.
* 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 in expansion markets to achieve quality, cost management, and strategic business development objectives; develops and negotiates strategic provider contracts on behalf of the Plan.
* Leads the performance management/earnings improvement activities for the special product/program organization.
*Hires, trains, coaches, counsels, and evaluates performance of direct reports.
 
 Requires a BA/BS; 12+ years of relevant experience, including prior management experience in a managed care setting with operations, budgeting and forecasting, process improvement, or planning experience; or any combination of education and experience, which would provide an equivalent background. Experience in Health care management of Long Term Care or Specialty Product of HIV/AIDS or equivalent products strongly preferred. Proven ability to handle geographic expansion and execution of product line.

MPA, MPH, MSN or MBA with Health Care concentration preferred. RN or LMSW license preferred.
			
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