Senior Manager, MCO Plan Performance, HCI & Dual Programs

State of Illinois; Illinois; On-site; USD 110,000 - 160,000; Full time

Job summary

The State of Illinois Department of Healthcare and Family Services seeks a Senior Manager to oversee account management operations for Illinois' Managed Care Organization programs, including HealthChoice Illinois and dual eligible (Medicare/Medicaid) programs.

This strategic leadership role involves driving performance improvements, supervising MCO Account Managers, and representing the department in high-level stakeholder meetings.

Qualifications

• Four years of progressively responsible administrative experience overseeing Medicare programs, including dual eligibility.
• Four years of professional experience developing and implementing policies within a healthcare or medical organization.
• Four years of demonstrated experience establishing and maintaining effective working relationships with executive leadership and stakeholders.
• Four years of experience ensuring contract compliance for managed care health plans.
• Four years of experience supervising staff and managing team performance.

Responsibilities

• Oversee account management operations for Illinois' Managed Care Organization programs, including HealthChoice Illinois and dual eligible programs.
• Drive performance improvements across MCO programs and operations.
• Supervise MCO Account Managers and review performance metrics.
• Represent the department in high-level stakeholder meetings and discussions.
• Lead statewide initiatives to strengthen managed care operations and policy implementation.

Skills

Managed care

Medicaid/Medicare knowledge

Stakeholder collaboration

Policy development

Leadership and supervision

Contract compliance

Job description

The Department of Healthcare and Family Services seeks a Senior Manager to oversee account management operations for Illinois' Managed Care Organization programs, including HealthChoice Illinois and dual eligible (Medicare/Medicaid) programs. This strategic leadership role involves driving performance improvements, supervising MCO Account Managers, representing the department in high-level stakeholder meetings, and leading initiatives to strengthen managed care operations statewide. The ideal candidate brings deep expertise in managed care, Medicaid, and Medicare with exceptional communication and collaboration skills.

Key qualifications:

• Four years of progressively responsible administrative experience overseeing Medicare programs, including dual eligibility
• Four years of professional experience developing and implementing policies within a healthcare or medical organization
• Four years of demonstrated experience establishing and maintaining effective working relationships with executive leadership and stakeholders
• Four years of experience ensuring contract compliance for managed care health plans
• Four years of experience supervising staff and managing team performance
• Knowledge of medical concepts and operations, preferably related to managed care health plans