Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs: ' Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women ' Children's Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR ' Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions. ' Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.
Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve. Community is accredited by URAC for its health plan operations.
We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers. JOB SUMMARY The Director, Medicaid Growth and retention is responsible for the strategy development, and implementation of strategies to grow and retain our Medicaid lines of business.
Establishing initiatives aimed at three critical audiences: members, community partners and providers. Increase organic member growth and through retention efforts leading to an increase in market share. As the Director, Medicaid Growth and Retention you will collaborate with the sales teams and generate pipeline for sales leads for Marketplace and DSNP product lines.
The Director will build a partnership infrastructure and position CHC as a leader within the healthcare space while also developing programs to leverage growth opportunities. Develop and maintain partnerships with community business partners, development agencies, health care organizations, community centers and non-profit organizations serving low-income populations. JOB SPECIFICATIONS AND CORE COMPETENCIES Responsible for managing Medicaid product lines performance and driving the development and implementation of value-based programs and initiatives in support of business strategies.
Focus on growing Medicaid membership and put in place retention strategies. Develop clear strategy around Medicaid growth and retention, continuous measurement against CHCs pillar and key priorities, while developing a clear Integration/path for collaboration with the sales team and product development team. The ability to lead and energize staff through large scale, systemic change to reach a common goal, while managing a diverse workforce that delivers services to a complex client base.
Collaborate with senior leaders in efforts that enhance the quality-of-care delivery, improve outcomes, and improve the value delivered to our members. Capacity to look ahead strategically and grasp the future, envisioning the organizations role in the future. Partner with project teams to organize and conduct initiatives and projects, while negotiating and enlisting the support of key stakeholder groups.
Actively contributes to achievement of departmental goals, as identified in Departments annual business plan, including specific departmental processes. improvement plans, and other duties as assigned.
Education/Specialized Training/Licensure: Bachelors degree Business, Marketing, or related field. Masters Degree preferred Work Experience (Years and Area): 10 Years in managed care or 7 years in marketing or product sales experience. Management Experience (Years and Area): 7 years' experience in healthcare/product/services demonstrating increasing levels of responsibility.
Software Proficiencies: Microsoft Office Suite, CRM tools, call center operations