Vice President, UM Operations

CNSI and Kepro are now Acentra Health!  Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. 

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector. 

Acentra is looking for a Vice President , UM Operations to join our growing team.

Job Summary:

The purpose of this position has to provide overall planning, direction and control to assigned Care Management Utilization Management lines of business to achieve operating and financial goals. 

Job Responsibilities :

• Establish productivity expectations to ensure assigned programs achieve financial and contract targets.  Identify opportunities for further operational effectiveness through process improvement, re-design, automation, etc.
• Ensure headcount is right-sized to the operation, considering attrition rates and new customers, while meeting workload and financial targets. Develop and maintain an operational infrastructure that includes employee skill set requirements, gap analysis, performance management, and training plans. 
• Create and implement effective retention plans in conjunction with Human Resources. 
• Provide leadership, expertise and project management skills to drive unprecedented success in revenue growth.  Provide clear, direct communication to operational directors and other management to ensure consistent understanding of business opportunities, resource needs and profitability goals.
• Develop and implement performance measurement reporting system to monitor compliance with existing policies, procedures and other requirements of URAC, ISO, etc.
• Comply with contractual requirements within the operation by monitoring critical indicators, deliverables and budgets.  Continually evaluate priorities to determine if they are consistent with customer(s) objectives.    
• Research and interpret appropriate legislation and regulations to identify strategies, new product opportunities and opportunities to capitalize on market changes.   
• Develop and maintain trusted relationships with key market influencers to support the acquisition of new business.
• Participate in contract management strategy sessions, customer visits/presentation, and renewal activities.  Identify and engage in “Up-Selling” opportunities to current customers.  Identify, initiate, and support project initiatives that add value to the operations.  Act as resource, demonstrating the value of Acentra Health’s healthcare suite of products/services.   

Requirements

Required Qualifications

• Bachelor’s degree in health care administration, business administration, public health, nursing, health information administration, or related field required. 
• Position requires work experience in a complex, competitive environment with diverse racial, ethnic and socio-economic factors.
• Experience with contract administration functions.
• 5+ years of experience in program management of healthcare operations.
• 5+ years of experience working with Medicaid State Government healthcare entities. 

Preferred Qualifications:

• Unrestricted license as a registered nurse preferred.
• Master’s degree in a closely related field is strongly preferred
• 5+ years of utilization management preferred.

Benefits

Why us? 

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes. 

We do this through our people. 

You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career. 

Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.  

Compensation 

The pay range for this position is $150,000 - $208,900

“Based on our compensation program, an applicant’s position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.” 

Thank You!

We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

Visit us at Acentra.com/careers/

EOE AA M/F/Vet/Disability

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.