Apply on Employer Site

AmeriHealth Caritas · 3 weeks ago

Vice President Plan Operations & Administration

Southfield, MI

Full-time

Hybrid

Director/Executive

10+ years exp

AmeriHealth Caritas is seeking a Vice President of Plan Operations & Administration to lead operational strategy for the Michigan Blue Cross Complete Medicaid plan. This role will ensure compliance with contractual obligations and drive operational excellence while collaborating with various teams to achieve strategic objectives.

Health CareInformation Technology

H1B Sponsor Likely

Responsibilities

Ensure compliance with state program contractual and regulatory requirements, including benefit/payment rules, data submissions, and service-level standards

Collaborate with shared services to resolve operational issues through root cause analysis and timely implementation of solutions

Monitor performance metrics and process improvements, serving as liaison between the health plan and enterprise functions

Partner with Service Operations on major changes and enterprise initiatives

Lead cross-functional meetings to foster alignment and coordination across plan and shared services

Develop action plans for operational efficiency and cost containment in partnership with Finance and Clinical leadership

Assess and mitigate plan-specific risks in collaboration with the Enterprise Risk Management team

Provide strategic leadership and oversight for teams managing Provider Network Operations, Community Engagement & Outreach, and Data & Technical Services, ensuring alignment with organizational goals and operational excellence

Qualification

Medicaid operationsMedicare operationsLeadership experienceHealthcare managementOperational strategyCompliance knowledgeRisk managementCross-functional collaboration

Required

A bachelor's degree is required

Minimum 5 years of experience in Medicaid/Medicare operations with progressive leadership responsibilities

10 plus years of progressive experience in business, government, or healthcare management

Deep understanding of Medicaid/Medicare operations and benefit administration

Proven ability to navigate complex, matrixed organizations

Company

AmeriHealth Caritas

Glassdoor3.4

AmeriHealth Caritas is the health care solutions provider for those in most need and the chronically ill.

Founded in 1982

Philadelphia, Pennsylvania, USA

10001+ employees

http://www.amerihealthcaritas.com

H1B Sponsorship

AmeriHealth Caritas has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (18)

2024 (17)

2023 (12)

2022 (14)

2021 (4)

2020 (11)