Vice President, Health Services

The Vice President, Health Services (VP HS) is a key executive on the senior management team of AlohaCare, with primary responsibility for the strategic and operational oversight of the Care & Service Coordination and Utilization Management departments. The VP HS is accountable for improving the effectiveness, efficiency and productivity of each department. Priorities include oversight of benchmarks that impact the MLR (Medical Loss Ratio). The VP HS participates in strategy development across the organization, fostering and exemplifying collaboration, coordination, and communication. This is a team-oriented role that develops and mentors their direct reports to fulfill their leadership potential. The position requires a leader who possesses the ability to form partnerships with providers, public and social agencies, other health plans, and MedQUEST. While this position ensures contractual and regulatory compliance, the VP HS also promotes innovation, creative problem solving, and diversity of ideas.

About the Culture:

AlohaCare’s leadership empowers and engages its employees through frequent diversity, recognition, community, and educational events and programs. AlohaCare has a strong commitment to support Hawaii’s families and reinforces a healthy work/home balance for its employees.

About the Position:

The VP, Health Services is accountable for improving the effectiveness, efficiency, and productivity of the Care & Service Coordination and Utilization Management departments.

The Successful Candidate Will:

  • Provide oversight of benchmarks that impact the MLR.
  • Safeguard contractual and regulatory compliance while promoting innovation, creative problem solving, and diversity of ideas.
  • Participate in strategy development across the organization, fostering and exemplifying collaboration, coordination, and communication.
  • Mentor direct reports to fulfill their leadership potential through a team-oriented leadership style.
  • Possess the ability to form partnerships with providers, public and social agencies, other health plans, and MedQUEST.

Sample Goals:

  • Prepare for RFP contract period.
  • Review and refine processes and workflows.
  • Optimize Medical Loss Ratio.
  • Enhance collaboration and communication between Care & Service Coordination and Utilization Management teams

Required Qualifications:

  • Licensed Clinician (RN, APRN, NP, LCSW, LMFT etc.) or PhD or PsyD.
  • Bachelor’s degree in public health, health administration, nursing, social work, or a related field; Masters preferred.
  • 8+ years in health services, with majority of time spent in executive leadership role.
  • 5+ years in Medicaid and/or Medicare programs.
  • 3+ years in managed care and/or care management.
  • Utilization Management and Care Coordination experience.
  • Clinical program development and implementation experience.

For more information, see here.