Divisional Vice President Service Delivery Operations - Medicaid Appeals & Grievances

At HCSC, building a talent engine for the future is a key priority because we recognize that as our business evolves to reflect the changing world, we must adapt our workforce to meet this challenge. Additionally, with "excellence" one of our core values, we are focused on improving our success measures and delivering the best possible customer experience.

JOB PURPOSE:
This position is responsible for overall performance management of Medicaid Appeals & Grievances (Medicare & Medicaid). This role will be responsible for implementing and refining processes to improve quality and efficiency while maintaining compliance with regulatory requirements and contractual obligations. It will lead development of staffing models, capacity forecasts and other operational reports to support performance expectations and provider leadership insights. It will work closely with other operational and line of business leaders to support internal and external audit activities.

JOB REQUIREMENTS:
• Bachelor's Degree required and 8 years of relevant work experience at a management consulting firm including experience leading high profile complex projects and delivering on initiatives within a highly matrixed organization OR 12 years of relevant work experience at a management consulting firm including experience leading high profile complex projects and delivering on initiatives within a highly matrixed organization.
• 4 years of client engagement leadership experience
• 2 years of management experience
• Strong negotiation, decision-making, organizational and analytical skills
• Flexibility and experience managing multiple projects and demands concurrently
• Healthcare or health solutions industry experience
• Experience in developing and presenting ideas/recommendations to executive level management as well as audiences external to the organization
• Ability to provide guidance to develop and execute complex analysis and presentation skills for executive audience
• Executive Presence and influence
• Strong business acumen as demonstrated by the ability to assimilate information quickly, identify gaps, and recommend improvements
• Collaborative yet proactive approach with the ability to anticipate and minimize roadblocks through understanding and partnership
• Project management experience
• Advanced Microsoft Office knowledge, modeling and presentation skills

PREFERRED JOB REQUIREMENTS:
• Prior work experience in consulting, health insurance, investment banking, and/or strategy functions in a large organization and in engagement leadership roles
• Experience in Medicaid

HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Requirements: Expertise Other Job Type Full-Time Regular Location IL - Chicago, TX - Richardson


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