Overview
Amida Care, the largest Medicaid HIV Special Needs Plan in NY, delivers a uniquely effective care model that has become a true benchmark for innovation, engagement and member health outcomes. Our mission is to provide access to comprehensive care and coordinated services that facilitate positive health outcomes and general well-being for our members. This true integrative care model addresses psychosocial, housing, behavioral and medical services directly evolving around the needs of each member.
We are a community of individuals from diverse peoples who work together to actively foster a fair, equitable, inclusive environment where all employees receive an invitation to belong. Visit [webpage] for more information about the Amida Care culture.
We are actively seeking a highly motivated, innovative and experienced leader to join our team as the Senior Director of Provider Relations. This position will be a member of the senior management team. Compensation will be commensurate with experience.
Position Summary:
This position is responsible for supporting Health Services (HS) management with planning, monitoring, leading, reporting and evaluating of projects activities to help ensure the achievement of department goals/objectives. Assist with the development and management of project plans for approved department projects to ensure project commitments are itemized, scheduled, resourced and met.
Responsibilities:
· Facilitate the development and implementation of a broad, coordinated set of plans and programs to meet the goals and priorities of the department.
· Partner with Health Services leadership on projects as assigned, on projects such as new benefit roll-out and others as assigned
· Complete administrative tasks within the Long Term Support and Services (LTSS) area
· Partner with gender affirming surgery utilization management team on projects/tasks as needed, such as completing assessments, calling member to notify of determinations and others as needed.
· Review and complete member eligibility verification ensuring regulatory timeframes are met
· Participate in UM operational processes with knowledge of Care Compass UM system
· Collaborate with HS leaders to coordinate implementation of projects and process changes. Collaborate with teams to create, monitor, and report on project progress and, as needed, corrective action plans.
· Track and maintain project schedules and meetings.
· Coordinate New Benefit Management process including; coordination with Third Party Administrators around benefit administration, update and review Amida Care Benefit Guide, ensure new benefits from all lines of business (LOB) are implemented following all regulatory and agency protocols.
Amida Care is Diversity, Equity and Inclusion employer committed to full inclusion and elimination of discrimination in all its forms. We strive to develop, promote and sustain a culture that values equity and leverages diversity and inclusiveness in all that we do.
EDUCATION REQUIRED
· Associate’s degree in business, process management, or a similar field or an equivalent combination of education and experience is required.
EXPERIENCE AND/OR SKILLS REQUIRED:
· One (1) to three (3) years of supporting project management team
· Strong knowledge of Microsoft Office (Visio, Project Management, PowerPoint, Word, Excel, and Access).
· 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.