Amida Care · 4 months ago
Vice President of Operations
New York, NY, US
Full-time
Onsite
Mid, Senior Level, Lead/Staff
$235K/yr - $245K/yr
10+ years expAmida Care, the largest Medicaid HIV Special Needs Plan in NY, delivers innovative care models aimed at improving member health outcomes. The Vice President of Operations will oversee operational aspects of the organization, ensuring efficiency and compliance while managing key departments and vendor relationships.
Child CareHealth CarePharmaceutical
Responsibilities
The Vice President of Operations will provide leadership and administrative report to the Claims/Encounter, Reporting, Provider Services, Credentialing and Vendor Management Teams
Responsible for ensuring a comprehensive cost efficient and accessible provider network that is contracted and linked to appropriate fee schedules
Manages the end-to-end contracting process, including credentialing, outreach, recruitment, contract initiation, and provider services for all risk arrangements including Valure Based providers
Proactively identifies risks and opportunities for improvement by utilizing a data driven mind set to solution and improve operations through automation and workflow redesign
Provide leadership, management, and vision necessary to ensure that the company has the proper operational controls, administrative and reporting procedures, and people systems in place to effectively grow the organization and to ensure financial strength and operating efficiency
Strategic though leader responsible for claims insights and analytics to drive efficiency and financial responsibility, are also critical aspects of the role
Drives the development, negotiation, and execution of vendor contracts, including RFIs, RFPs, Statements of Work (SOWs), and final agreements, ensuring alignment with business, clinical, and financial goals
Build and maintain relationships with key internal and external stakeholders to ensure the successful outcome of business objectives and goals
Accountable for ensuring departmental compliance with contractual, regulatory, and corporate requirements, guidelines, and goals including turnaround times, timely submissions, and reporting
Oversee implementation / project management both contractually and operationally for new vendors and third-party software outside of IT
Ensures efficient processes and proper follow-up with our external vendors
Development of key metrics and KPIS for operational effectiveness
Oversee monitoring of the vendor process of to ensure and monitor process of timely submission and error corrections and resubmissions
Responsible for the hiring and retention of quality staff and the on-going planning, monitoring, training, coaching, evaluation, and appraisal of staff performance and development to ensure successful achievement of goals and objectives
Other duties as assigned
Qualification
Required
Bachelor's degree combined with 10+ years of experience in Health Plan Operations and Information Technology
Over 10 years of progressive Managed Care experience spanning claims, provider contracting, and vendor management
Extensive background with New York State Medicaid in a health plan environment, including more than five (5) years in senior-level roles
In-depth working knowledge of Medicaid regulatory reporting requirements (e.g., MMCOR, SNPOR) for the New York State Department of Health and CMS
Strong analytical, innovative, and critical thinking skills
Collaborative and inclusive leadership style. Open to feedback and considering new ideas and approaches
Exceptional interpersonal and verbal/written communication skills
Strong computer skills, including MS Office (EXCEL, Word, Power Point)
Demonstrate understanding and sensitivity to multi-cultural values, beliefs, and attitudes of both internal and external contacts
Demonstrate appropriate behaviors in accordance with the organization's vision, mission, and values
Company
Amida Care
Amida Care is an organization providing healthcare, meals, advocacy, research and social services.
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
Doug Wirth
President/CEO
Alex Fontanez
Associate Director of Partnerships & Ombudsman
Recent News
2025-11-19
Company data provided by crunchbase