Florida Licensed Health Plan Director

Job Summary

Leading health plan operations, the full-time Florida Licensed Health Plan Director will manage the development and administration of operational functions, ensuring compliance and alignment with member satisfaction and financial goals while working remotely.

Key responsibilities

• Organizes and coordinates health plan operations for designated lines of business, collaborating with senior leadership
• Oversees provider network administration and claims operations, ensuring regulatory compliance and accurate claims payment
• Implements strategies to improve member satisfaction and retention, while managing team performance and development

Required qualifications

• At least 8 years of experience in health care operations, administration, or provider services
• A minimum of 3 years of management or leadership experience
• Advanced knowledge of Medicare, Medicaid, and Marketplace plans
• Experience with prompt pay laws and claims-related processes
• Project management experience with strong organizational skills