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Chief Operating Officer

Chief Operating Officer

Date: 10/23/2014

Description: Under direction of the Chief Executive Officer, plans, directs, monitors, coordinates, interprets and administers all functional activities and policies related to Claims, Member Services, Provider Relations, AIS/Compliance departments.

This is a single classification, reporting to the Chief Executive Officer of KHS.  Executive is responsible for directing all activities of the Claims, Provider Relations, and AIS/Compliance departments for a Knox-Keene Act-licensed health maintenance organization.  Executive falls at both the policy and decision making level of activity and, because of staff’s limited managed care experience, at the technical level of activity.  Executive maintains authority for setting policies and procedures for the departments, that are consistent with the policies and procedures set by the KHS Board of Directors and the Chief Executive Officer, and fall in compliance with regulatory requirements.  Executive is responsible for and has decision making authority regarding the organization in the absence of the Chief Executive Officer.

Requirements: Bachelor’s degree from an accredited university AND a minimum of five (5) years of health services management at the upper management level in the managed health care or insurance industry, five (5) years of experience preferable in a state-licensed health maintenance organization OR eight (8) years of management at the upper management level in the managed health care or insurance industry, preferably in a state-licensed health maintenance organization in place of a Bachelor’s degree.  A Master’s degree in health care administration is highly desirable. Experience in capitated managed health care and/or startup organizational development is strongly preferred. Knowledge of health care industry; management principles; quality improvement and utilization management; provider contracting; member services; complaint/grievance resolution; and other functions required by the position.

We have an excellent benefit package to include: health care, dental, life, 457b and 401a plan, and other supplemental benefits.  As a condition of employment, a satisfactory drug test and background check are required. E.O.E.

Req# 180-14