General Manager, PHP, NM (Behavioral Health)- Remote (Finance)

• Magellan serves as behavioral health vendor to Presbyterian Health Plan, serving 300K+ Medicaid, Medicare and commercially covered members.
• PHP/Magellan is also the sole care coordination entity for the Children in State Care (CISC) program as of July 2024.
• Leader must have ability to have high-touch engagement with client and be flexible to changing deliverables in a fast-paced, demanding environment.
• Strong interpersonal skills as well as deep knowledge of health plan operations required.

Leads operations for a Care Management Center (CMC), Health Plan, Program, or Product to ensure operational success and compliance in meeting clinical, quality, customer, business financial, and employee targets and objectives. May partner with account managers to achieve a high degree of customer service. Ensures cost effective approach to processes and deliverables for assigned business unit, program or product.

• Manages financial performance, operating budget and variances from plan to ensure cost effective delivery of service. Responsible for development and implementation of annual operating budget.
• Oversees compliance to all operations performance standards. Develops and activates action plans to bring back in compliance when standards are not met.
• Responsible for developing and fulfilling service level agreement with Account Management.
• Creates and manages high-performing cross-functional, matrixed team, ensuring staff provide appropriate and efficient services. Continually monitors services and programs to ensure that client needs and contract obligations are being met in accordance with policies and procedures.
• Directs the delivery of high-quality services and ensures that quality management plans and protocols are implemented and that services are delivered in accordance with policies and procedures. Monitors quality assurance indicators and provides quality oversight.
• Manages high-risk cases and utilization trends. Provides required management reports to internal and external customers and clients.
• Coordinates network provider activities.

Other Job Requirements

Responsibilities
10+ years experience in healthcare with a clinical and/or operations management focus.
4 years management level experience in the managed healthcare industry required.
Thorough knowledge of managed healthcare principles and call center operations.
Understands financial and quantitative information and has ability to manage operations within budgets.
Ability to identify problems, recognize symptoms and causes and establish and implement solutions.
Ability to develop effective teams, through awareness of opinions, resolving conflicts and building collaboration among all levels in the organization.
Ability to achieve organizational goals through development of effective teams.
Motivates and empowers others to attain personal and team goals.
Demonstrates excellent negotiation and communication skills.

General Job Information

Title
General Manager, PHP, NM (Behavioral Health)- Remote

Grade
32

Work Experience - Required
Management/Leadership, Operations

Work Experience - Preferred

Education - Required
Bachelor's

Education - Preferred
Master's

License and Certifications - Required

License and Certifications - Preferred

Salary Range

Salary Minimum:
$127,295
Salary Maximum:
$229,105

This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.

This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.

Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.