Texas Children's Hospital

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Director of Business Operations - Health Plan

at Texas Children's Hospital

Posted: 9/22/2019
Job Reference #: 18294
Keywords: operations

Job Description

  • Requisition ID
    Talent Area
    Professional - Non-Clinical
    Full/Part Time
    Shift Description
    8a - 5p
  • Job Summary

    We are looking for a Director of Business Operations – someone who works well in a fast-paced setting. In this position, you will plan, organize, and direct the operations of the health plan. You will provide leadership and oversight for health plan activities related to Medicaid and CHIP and to ensure all are administered to ensure compliance with federal and state guidelines, along with other regulatory bodies that govern the operations of the organization. You’ll also assist leaders with the development and implementation of policies and procedures related to the guidelines provided by the federal and state governments and other regulatory bodies.

    Think you’ve got what it takes?


    Job Duties & Responsibilities

    • Partners with department leaders to drive operations decisions regarding various functional areas of the health plan
    • Identifies key stakeholders and engages leaders in the decision-making processes
    • Assists leaders with the development and implementation of policies, procedures, and guidelines to drive compliance with federal and state guidelines
    • Conducts periodic evaluation of operational processes to ensure compliance is maintained
    • Provides metrics and reports to monitor and track the status of operations. Works collaboratively with the appropriate groups to identify and prioritize opportunities for improvements
    • Serves as a member and decision-maker of the hospital’s Medical Policy and Reimbursement Committees and provides guidance and input into the operational issues presented before these groups or others as appropriate
    • Collaborates with leaders and others within the institution regarding cost of care initiatives and/or other strategies to be implemented across the system


    Skills & Requirements

    • Bachelor’s degree in healthcare administration, business administration, or related field
    • Lean Six Sigma Certification preferred
    • 8 years’ experience in health plan operations, including four years of management or leadership experience

    Company Profile

    Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.

    To join our community of 14,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.

    Not ready to apply? Connect with us for general consideration.