The Operations Implementations & Integrations Director is a highly organized, detail-oriented, and execution-focused individual who will serve as a partner in coordinating greenfield growth and acquisition integration initiatives across key operational areas. This role will lead cross-functional execution for initiatives spanning Provider Data (including credentialing and directory maintenance), Enrollment, Benefit Coding & Support, Payment Integrity, and Operations Data. This individual will act as a strategic liaison with the Implementation Management Organization and provide program-level oversight to ensure seamless, timely, and high-quality operational readiness for all new markets and integration efforts.
Essential Functions:
Lead and coordinate the operational implementation and integration of new markets, products, and acquisitions across core operational teams
Collaborate with internal departments and the Implementation Management Organization (IMO) to manage project timelines, interdependencies, and deliverables
Track and drive execution of critical milestones across multiple concurrent initiatives
Facilitate decision-making, remove obstacles, and escalate risks as needed to ensure delivery of key operational outcomes
Coordinate alignment of systems, processes, data flows, and stakeholder responsibilities for seamless integration into enterprise operations
Support the planning and execution of benefit research and design, provider onboarding, member enrollment, payment integrity, and downstream data flow into claims and analytics systems
Establish a consistent framework for communication, documentation, and status tracking across all implementation efforts
Develop reporting and communication tools to keep senior leadership informed of progress, risks, and resource needs
Ensure consistency and quality of implementation standards across departments
Serve as a delegate in cross-functional implementation meetings and strategic planning sessions
Support continuous improvement initiatives related to implementation and integration processes
Perform other duties as assigned
Education and Experience:
Bachelor's Degree in Business Administration, Healthcare Administration, Operations, or related field is required. Master's Degree is preferred.
Minimum of eight (8) years of experience in health insurance operations, program management, or enterprise implementations is required
Proven experience managing cross-functional programs, preferably in a health insurance or health tech environment
Proven experience supporting or leading implementation and integration of new markets and acquired entities
Competencies, Knowledge and Skills:
Strong knowledge of provider data, enrollment, claims, and operational systems within a health plan setting
Exceptional project/program management and organizational skills
Proven ability to coordinate and align multiple stakeholders toward shared goals
Detail-oriented with the ability to manage complexity across multiple workstreams
Strong communication and influencing skills, capable of representing executive leadership in cross-functional forums
Comfortable with ambiguity and shifting priorities in a dynamic environment
High level of accountability and commitment to execution excellence
Demonstrated success in managing initiatives with high strategic importance and visibility
Licensure and Certification:
None
Working Conditions:
General office environment; may be required to sit/stand for long periods of time
Compensation Range:
$132,900.00 - $232,700.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In additi
Job ID: 481999895
Originally Posted on: 6/19/2025
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