Florida Licensed Health Plan Director

Job Summary

A company is looking for a Director of Health Plan Operations who must reside in Florida.

Key Responsibilities

• Leads and coordinates health plan operations for designated lines of business, ensuring compliance and alignment with goals
• Collaborates with senior leadership and corporate functions to enhance provider and member service strategies
• Oversees provider network administration, claims operations, and member retention strategies to improve satisfaction

Required Qualifications

• At least 8 years of experience in health care operations, administration, or provider services
• Minimum of 3 years in a management or leadership role
• Advanced experience with Medicare, Medicaid, and Marketplace plans
• Experience with prompt pay laws and claims-related processes
• Project management experience and proficiency in Microsoft Office suite