NorthCare Network seeks an experienced Chief Executive Officer to join our dedicated team. NorthCare is the Prepaid Inpatient Health Plan (PIHP) for the entire Upper Peninsula region with the CEO located in Marquette, Michigan. The ideal candidate will provide leadership and administrative excellence while ensuring that PIHP functions are carried out in a manner that improves the lives of Medicaid funded individuals living in the Upper Peninsula region. The CEO serves as the spokesperson for the region and is the interface between the Michigan Department of Health & Human Services (MDHHS), the Community Mental Health Service Providers, Substance Use Disorder and Community Providers for all Medicaid funded services. The CEO manages programs in accordance with MDHHS and the rules/regulations of applicable local, state and federal regulatory bodies. This position reports to and is directed by a Board of Directors.
PRIMARY RESPONSIBILITIES OF THE CEO:
Overall responsibility for strategic planning, direction and supervision of NorthCare Network operations.
Implementation and review of Managed Care Requirements per MDHHS contract (including 7 administrative management functions: General, Financial, Information Systems, Provider Network, Utilization, Customer Services & Quality Management.)
Oversee the development, implementation and reporting of the annual budget and fiscal plan to include all financial reporting required by local, state and federal funding sources.
Oversee the annual review, evaluation and management of clinical and administrative services goals and objectives, consistent with the quality improvement plan of the network.
Oversee the submission of all required reports per MDHHS contract.
Oversee Mandatory Managed Care Duties including: Utilization Management, Provider and/or Consumer Appeals, and Care Coordination among Providers.
Represent NorthCare Network at MDHHS and other venues, as directed.
Participate in monthly Regional Governing Board and other advisory committee meetings.
Serve as a spokesperson for public information and media relations at the local/regional/state level.
Assure compliance w/Mental Health Code, MDHHS contracts & licensing rules, state and federal laws.
Assure monitoring of all psychiatric inpatient admissions and continuing stay reviews for service area.
Assure coordination of provider and consumer appeals, where appropriate.
Assure approved authorizations and related forms are complete and processed accordingly.
Provides leadership for the NorthCare Credentialing Program; chairs NorthCare Leadership and NorthCare Credentialing Committees; serves as senior clinical staff person responsible for oversight of clinical aspects of the credentialing program.
Coordinate services with other CMHSP professional staff, programs or agencies as needed.
Provide direct supervision of the Chief Financial Officer, Chief Information Officer, Medical Director, Compliance Officer, Substance Abuse Prevention Treatment Director and other NorthCare staff.
Extensive travel is required for meetings and various other work responsibilities.
WHAT YOU NEED TO SUCCEED AS THE NORTHCARE NETWORK CEO:
Master’s Degree in Social Work or Psychology, preferred; Master’s in Finance, Business Administration, Public Administration or Health Administration will be considered.
5 years’ administrative experience in a mental health setting with a background in populations served by the Prepaid Inpatient Health Plan (PIHP), desired.
State of Michigan professional license in Social Work or Psychology, preferred.
Possess a leadership style that is ethical, inspires, motivates, and develops lasting relationships.
Knowledge/understanding of the Michigan Mental Health Code and managed care procedures.
Proficiency w/computers, web-based research, word processing, and e-communication.
Experience with finance and long-term management planning for a $90+ million-dollar organization.
Willingness and ability to relocate to Marquette, Michigan (or the surrounding area).
APPLY ONLINE at northcare.sdsjobs.com. No phone calls or walk-ins, please. Applications accepted until position is filled.
Additional Salary Information: Extremely competitive salary and benefit package.