Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:
Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women
Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR
Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.
Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.
Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.
Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.
Skills / Requirements
JOB SUMMARY
The Executive Director of the STAR+PLUS program will oversee the strategic direction, implementation, and ongoing management of the program. Responsibilities include navigating regulatory requirements, leading program launches, monitoring operational performance, and fostering collaboration with internal and external stakeholders to ensure program success while adhering to regulatory, scope, budget, time, and quality parameters.
JOB SPECIFICATIONS AND CORE COMPETENCIES
Program Leadership And Implementation
Lead and coordinate the implementation of the STAR+PLUS program.
Ensure compliance with regulatory standards and operational excellence.
Manage project plans and critical paths effectively.
Resource Management And Oversight
Utilize matrixed resources to manage program deliverables.
Escalate issues, drive operational compliance, and address gaps as needed.
Ensure efficient use of resources and maintain program quality.
Stakeholder Management
Serve as the primary liaison with State partners for program activities.
Collaborate with internal and external stakeholders to drive program success.
Subject Matter Expertise And Business Strategy
Act as an expert in STAR+PLUS services and industry best practices.
Develop business case methodologies for program initiatives.
Operational Analysis And Improvement
Analyze program operations to identify efficiencies and best practices.
Implement operational improvements and best practices.
Qualifications
Education/Specialized Training/Licensure: Bachelor's degree in Healthcare, Business Administration, or a related field required.
Master's degree in Healthcare, Business Administration, or a related field preferred.
Work Experience (Years and Area): Minimum of 12 years of experience in managed healthcare, particularly in Medicaid (STAR+PLUS/STAR Kids) and/or Medicare
Management Experience (Years and Area): 6 years of management experience in a related area
Software Proficiencies: Proficiency in Microsoft Office applications (Word, Excel, Outlook)
Other: Ability to travel within Houston, surrounding counties, and Austin, TX as needed
Seniority level
Director
Employment type
Full-time
Job function
Business Development and Sales
Industries
Hospitals and Health Care
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