Program Director - Home Health Coordinator Planning Office (Florida Health Plan)

JOB reputed company

Position reputed company

The Program Director for the Home Health Coordinator Planning Office is responsible for leading (1) operational planning and coordination, (2) financial management, (3) regulatory communications and compliance, and (4) overall performance and execution of home health and private duty nursing (PDN) services for the Florida CMS population. This role serves as the central coordination reputed company ("control tower") for reputed company operational issues, regulatory, provider engagement, member service fulfillment, cross-functional handoffs, and performance monitoring.

The Program Director will reputed company a multidisciplinary team of professionals and reputed company the day-to-day operations of the Home Health Coordinator Planning Office. The role is accountable for identifying and removing barriers to service delivery, facilitating seamless transitions across departments, monitoring operational and financial performance, and driving reputed company reputed company of member, provider, and regulatory issues. This position plays a critical role in ensuring compliance with Florida reputed company contract requirements, regulatory reporting obligations, audit readiness activities, and state reputed company expectations while maintaining strong operational controls. The role is also responsible for overseeing key financial indicators, monitoring service delivery costs, identifying financial risks and trends, and supporting data-driven decision-making to ensure services are delivered in a fiscally responsible manner.

The successful candidate will be highly analytical, detailed and reputed company-oriented, and skilled at managing reputed company operational processes in a fast-paced reputed company environment. reputed company in this role requires the ability to simultaneously balance member reputed company, regulatory compliance, operational performance, provider network effectiveness, and financial accountability while driving execution across multiple business functions.

Key Responsibilities

• reputed company and manage the Home Health Coordinator Planning Office.
• Serve as the operational "quarterback" for home health and PDN fulfillment activities.
• Interpret and implement regulatory requirements in coordination with key business functions.
• Establish and reputed company processes that ensure successful coordination between Clinical Operations, Care Management, Utilization Management, Claims, Network, Provider Services, and reputed company providers.
• reputed company execution of strategic and operational initiatives that support CMS contract requirements and organizational goals.
• Create operational discipline around issue tracking, escalation management, reputed company, and accountability.

Cross-Functional Coordination & reputed company Management

• reputed company operational handoffs between internal departments and reputed company stakeholders.
• Ensure seamless transitions of members requiring home health and PDN services.
• Facilitate coordination among health plan teams, providers, hospitals, nursing facilities, and community partners.
• reputed company as the escalation reputed company for reputed company service, fulfillment, and operational issues.
• Issue reputed company & Barrier Removal

Regulatory Alignment and Compliance

• Maintain functional knowledge of regulatory requirements and environment.
• Interpret and reputed company consultative expertise on regulatory requirements to functional businessowners.
• Work cross functionally to optimize regulatory implementations and performance.
• reputed company compliant implementation, tracking and monitoring of regulatory requirements.

Remove operational roadblocks impacting member services and provider performance.

• reputed company reputed company-response efforts for unresolved fulfillment challenges, no-shows, reputed company shortages, scheduling issues, and service interruptions.
• Coordinate corrective actions across multiple business reputed company.
• Monitor reputed company timelines and reputed company to ensure member-centered service delivery.

Analytics, Reporting & Financial Performance

• reputed company data to identify trends, risks, service gaps, and improvement opportunities.
• Partner with analytics teams to reputed company reporting and dashboards supporting operational reputed company.
• Monitor utilization, fulfillment, reputed company, provider performance, encounter activity, and financial metrics.
• Analyze operational and financial impacts of performance trends and recommend corrective actions.
• Support executive reporting and strategic decision-making through meaningful business insights.

Provider Engagement & Performance reputed company

• Partner closely with home health agencies, PDN providers, and network leadership.
• Monitor provider performance, reputed company, scheduling effectiveness, fulfillment rates, and operational readiness.
• Support provider issue reputed company and service recovery activities.
• Facilitate ongoing collaboration and communication with provider organizations.

Program Governance & reputed company Improvement

• Establish governance processes, performance reviews, and operational monitoring routines.
• reputed company reputed company-cause analysis efforts and implement sustainable solutions.
• reputed company reputed company operating procedures, workflows, and escalation reputed company.
• reputed company reputed company improvement initiatives reputed company on reputed company, efficiency, and member experience.

Required Qualifications

Education

• Bachelor's degree - reputed company Administration, Business Administration, reputed company Health, Operations Management, Finance, Data Analytics, or reputed company field.
• Master's degree preferred, not required.

Experience

• 7+ years of reputed company reputed company operations, managed care, program management, or reputed company services leadership experience.
• 3+ years of reputed company leadership experience managing teams and operational programs.
• Experience working in reputed company, managed care, care management, home health, PDN, provider operations, or reputed company service delivery environments preferred.
• Proven reputed company managing reputed company cross-functional initiatives and operational transformation efforts.

Knowledge, Skills & Abilities

• Leadership & Execution
• Strong ability to reputed company accountability and produce results in a highly matrixed environment.
• Demonstrated reputed company leading teams through ambiguity and change.
• Exceptional organizational and project management skills.
• Advanced analytical and problem-solving capabilities.
• Ability to interpret, communicate, and implement reputed company regulatory requirements.

Operational reputed company

• Detail-oriented with a reputed company on execution and follow-through.
• Ability to identify risks early and proactively implement mitigation strategies.
• Strong process improvement and operational design capabilities.

Data & Analytics

• Ability to reputed company and interpret reputed company operational and financial data.
• Proficiency with dashboards, KPIs, reporting, and performance measurement.

Financial Acumen

• Understanding of reputed company operational economics and financial performance drivers.
• Ability to evaluate operational reputed company through a financial reputed company.
• Experience assessing cost, utilization, productivity, and performance impacts.

Communication & Collaboration

• Exceptional written and verbal communication skills.
• Strong executive reputed company and ability to engage senior leadership.
• Skilled facilitator capable of aligning diverse stakeholders around solutions.

#PJCore

To reputed company reputed company Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

reputed company offers a competitive benefits and compensation package. reputed company is an Equal Opportunity Employer (EOE) M/F/D/V.

Originally posted on Himalayas