Health Plan Operations Chief (COO)

MetroPlusHealth; New York (NY); On-site; USD 350,000 - 650,000; Full time

Job summary

MetroPlusHealth in New York is seeking a Chief Operating Officer to provide leadership for operational systems, member services, facilities, and claims management, with accountability for Medicaid operations. The COO will drive efficiency, quality, and financial strength while upholding the plan's mission.

The role partners with the Executive Staff and the Board to steer growth, improve member experience, and foster a culture of excellence across all operational lines in a dynamic healthcare

Qualifications

• Bachelor’s degree in a related field is required.
• Master’s in business, healthcare or public administration strongly preferred.
• At least 10 years of senior/executive level experience in the healthcare field.
• 5+ years at VP/SVP/EVP level or higher in a Managed Care Organization in an operational role.
• Experience managing teams of 50+ members.
• Experience and knowledge related to customer experience and service.
• Thorough knowledge of management principles and practices, including process and quality improvement methods.
• Broad and deep knowledge of managed care operations and related technologies.
• Demonstrated knowledge overseeing a diverse array of managed care product lines, claims processing and call center operations.
• Experience with Project Management tools to improve offerings and services.
• Strong IT and finance background a plus.

Responsibilities

• Provide day-to-day leadership across facilities, member services, and claims operations.
• Develop and implement operational systems, controls, and reporting.
• Ensure effective execution of strategic priorities and transformation initiatives.
• Collaborate to establish direction and alliances for strategic results.
• Maintain high level of member experience through call center oversight.
• Oversee billing, claims processing, and operational infrastructure for growth.
• Mentor, coach, and develop staff while upholding MetroPlusHealth culture.
• Represent MetroPlusHealth with external groups and committees.
• Drive improvements in information systems and interdepartmental collaboration.
• Lead governance, policy formation, and strategic planning activities.

Education

Bachelor's degree

Master's degree preferred

Job description

MetroPlusHealth in New York is seeking a Chief Operating Officer to provide leadership for operational systems, member services, facilities, and claims management, with accountability for Medicaid operations. The COO will drive efficiency, quality, and financial strength while upholding the plan's mission.

The role partners with the Executive Staff and the Board to steer growth, improve member experience, and foster a culture of excellence across all operational lines in a dynamic healthcare