Executive Leader, Managed Care & Compliance

Southwest Michigan Behavioral Health; Portage (MI); Presencial; USD 140.000 - 199.000; Jornada completa

Descripción de la vacante

Southwest Michigan Behavioral Health in Portage, MI is seeking a Chief Managed Care Officer to lead our managed care operations as a key member of the executive leadership team, overseeing program integrity, compliance, customer services, and provider network management across the region.

You will set strategic direction for executive managed care functions, ensure Medicaid managed care regulatory compliance, oversee Program Integrity, SIU and Customer Services leadership, and partner with legal

Formación

• Bachelor's degree required in a related field.
• JD or Master's degree strongly preferred.
• 8+ years of progressive leadership in managed care, Medicaid, or healthcare compliance.
• Deep knowledge of PIHP operations and complex contract terms.

Responsabilidades

• Provide executive oversight of program integrity and compliance.
• Oversee Customer Services leadership and provider network management.
• Advise CEO on managed care risk and strategy.
• Negotiate and operationalize complex provider agreements.

Conocimientos

Executive leadership

Regulatory compliance

Provider network management

Contract negotiation

Cross-functional leadership

Risk & governance

Educación

Bachelor's degree in related field

Juris Doctor or Master's preferred

Herramientas

Microsoft Office 365

Descripción del empleo

Southwest Michigan Behavioral Health in Portage, MI is seeking a Chief Managed Care Officer to lead our managed care operations as a key member of the executive leadership team, overseeing program integrity, compliance, customer services, and provider network management across the region.

You will set strategic direction for executive managed care functions, ensure Medicaid managed care regulatory compliance, oversee Program Integrity, SIU and Customer Services leadership, and partner with legal