Strategic Health Director

3 days ago

Mission, British Columbia, Canada ASSOCIATION FOR COMMUNITY AFFILIATED PLANS Full time
About Association for Community Affiliated Plans

Association for Community Affiliated Plans (ACAP) is a unique opportunity to lead with purpose and make a transformative impact on the health and well-being of Ventura County residents.

We are an independent public entity governed by the Ventura County Medi-Cal Managed Care Commission and are dedicated to serving our members. Our member-first focus centers on the delivery of exceptional service to our beneficiaries by enhancing the quality of healthcare, providing greater access, and improving member choice.

Our Mission

We are committed to making a difference in the communities we serve. Through grants, sponsorships, and the fundraising efforts of our employees, we support the organizations that are making a difference in the lives of Ventura County's Medi-Cal members.

Our goal is to fulfill our vision of compassionate care, accessible to all, for a healthy community.

Role Overview

The Chief Executive Officer will maintain transparent communication and ensure the organization adheres to state and federal Medicaid regulations. The CEO will cultivate a high-performing executive team, prioritize diversity and equity, and foster a mission-driven culture that aligns with the organization's goals of addressing health inequities and improving care for underserved communities.

  • Build and maintain strong relationships with stakeholders, including state regulators, healthcare providers, advocacy groups, and community organizations.
Key Responsibilities

Operational Oversight:

  • Provide executive leadership for all operational functions, including enrollment, provider network management, claims administration, utilization management, quality improvement, and member services.
  • Ensure the organization meets key performance indicators (KPIs) related to access, quality, cost, and member experience.
  • Monitor financial performance, including revenue cycle management, risk adjustment, medical loss ratios (MLR), and D-SNP profitability, taking corrective actions as needed.
  • Negotiate and oversee contracts with healthcare providers, vendors, and other key partners to ensure cost-effective service delivery.

Regulatory Compliance and Governance:

  • Ensure compliance with all federal and state Medicaid regulations, including CMS guidelines, California's Medi-Cal managed care requirements, and D-SNP operational requirements.
  • Collaborate with Commissioners to maintain effective governance practices, provide regular updates on organizational performance, and implement Commissioner directives.
  • Oversee the preparation of required reports, audits, and certifications for regulatory bodies and funding entities.
Requirements

The ideal candidate will possess a Bachelor's degree in healthcare administration, business, public health, or a related field and at least 10 years of senior leadership experience in Medicaid managed care, healthcare administration, or a related field. A proven track record of managing large budgets, leading multidisciplinary teams, and achieving measurable improvements in operational performance and health outcomes is also required.

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