CareSource
Manager, Managed Care Licensing
CareSource, Dayton, Ohio, United States, 45402
Job Summary:
The Manager, Managed Care Licensing is responsible for coordinating the filing of new license applications, renewing existing licenses, and submitting holding company act filings
Essential Functions:Accountable for ensuring the timely and accurate filing of the Company's new license applications and renewal of the Company's existing licenses, including certificates of authority, third-party administrator, and utilization review licensesManage CareSource's licensing tracking software to ensure filings are made timely and that a record is kept of all materials filed with government agenciesProactively create workflows to enhance the Company's licensing processesCoordinate with business owners to gather documents and information in support of license filingsProvide support to the organization and teammates in assessing, interpreting, and incorporating new and revised regulatory and government contract requirementsStay up to date with federal/state laws and regulations, industry standards, and best practices regarding the Company's licensesReport key statistics and trends regarding the licensing processEducate other Company staff and leaders regarding license filing requirements, especially renewals, so deliverables are properly tracked and expectations for the responsible areas are set.Establish effective working relationships and build and maintain creditability within the organization to support a culture of compliance based on the Company's core valuesReport potential risks, non-compliance, or alleged violations to the Deputy General Counsel or Corporate Compliance OfficerIdentify performance improvement opportunitiesPotentially manage and/or oversee other staff performing licensing functionsPerform any other job duties as requested
Education and Experience:Bachelor's degree or equivalent years of relevant work experience is requiredA minimum of 5 years of experience in a healthcare related field or other highly regulated industry is requiredPrevious management experience is preferredProcess improvement or audit experience is preferredExperience filing license applications and renewals for health maintenance organizations, Life & Health insurers, third party administrators, and/or utilization review organizations, and insurance holding company filings is strongly preferred
Competencies, Knowledge and Skills:Adaptable and can drive for resultsStrong client service and teamwork skillsExcellent time/project management and prioritization skillsAbility to excel in a dynamic, fast-paced, environmentKnowledge of standards or controls management, preferably from a Managed Care OrganizationKnowledge of regulatory environment and ability to interpret regulationsWorking knowledge of health plan environmentStrong analytical and statistical skills and attention to detailAbility to work in a fast-past environment and reprioritizeEffective problem-solving skills with attention to detailStrong communication skills, including high-level writing and editing skills, and the ability to speak publiclyStrong interpersonal skills, a high level of professionalism and the ability to establish effective working relationships with key business partnersProficient in Microsoft Word, Excel, and PowerPoint
Licensure and Certification:None
Working Conditions:General office environment; may be required to sit or stand for extended periods of timeCompensation Range:$79,800.00 - $127,600.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.Compensation Type:SalaryCompetencies:- Create an Inclusive Environment- Cultivate Partnerships- Develop Self and Others- Drive Execution- Influence Others- Pursue Personal Excellence- Understand the BusinessThis job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.
The Manager, Managed Care Licensing is responsible for coordinating the filing of new license applications, renewing existing licenses, and submitting holding company act filings
Essential Functions:Accountable for ensuring the timely and accurate filing of the Company's new license applications and renewal of the Company's existing licenses, including certificates of authority, third-party administrator, and utilization review licensesManage CareSource's licensing tracking software to ensure filings are made timely and that a record is kept of all materials filed with government agenciesProactively create workflows to enhance the Company's licensing processesCoordinate with business owners to gather documents and information in support of license filingsProvide support to the organization and teammates in assessing, interpreting, and incorporating new and revised regulatory and government contract requirementsStay up to date with federal/state laws and regulations, industry standards, and best practices regarding the Company's licensesReport key statistics and trends regarding the licensing processEducate other Company staff and leaders regarding license filing requirements, especially renewals, so deliverables are properly tracked and expectations for the responsible areas are set.Establish effective working relationships and build and maintain creditability within the organization to support a culture of compliance based on the Company's core valuesReport potential risks, non-compliance, or alleged violations to the Deputy General Counsel or Corporate Compliance OfficerIdentify performance improvement opportunitiesPotentially manage and/or oversee other staff performing licensing functionsPerform any other job duties as requested
Education and Experience:Bachelor's degree or equivalent years of relevant work experience is requiredA minimum of 5 years of experience in a healthcare related field or other highly regulated industry is requiredPrevious management experience is preferredProcess improvement or audit experience is preferredExperience filing license applications and renewals for health maintenance organizations, Life & Health insurers, third party administrators, and/or utilization review organizations, and insurance holding company filings is strongly preferred
Competencies, Knowledge and Skills:Adaptable and can drive for resultsStrong client service and teamwork skillsExcellent time/project management and prioritization skillsAbility to excel in a dynamic, fast-paced, environmentKnowledge of standards or controls management, preferably from a Managed Care OrganizationKnowledge of regulatory environment and ability to interpret regulationsWorking knowledge of health plan environmentStrong analytical and statistical skills and attention to detailAbility to work in a fast-past environment and reprioritizeEffective problem-solving skills with attention to detailStrong communication skills, including high-level writing and editing skills, and the ability to speak publiclyStrong interpersonal skills, a high level of professionalism and the ability to establish effective working relationships with key business partnersProficient in Microsoft Word, Excel, and PowerPoint
Licensure and Certification:None
Working Conditions:General office environment; may be required to sit or stand for extended periods of timeCompensation Range:$79,800.00 - $127,600.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.Compensation Type:SalaryCompetencies:- Create an Inclusive Environment- Cultivate Partnerships- Develop Self and Others- Drive Execution- Influence Others- Pursue Personal Excellence- Understand the BusinessThis job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.