Manager, Managed Care Licensing

Job Summary:

The Manager, Managed Care Licensing is responsible for coordinating the filing of new license applications, renewing existing licenses, and submitting holding company act filings

Essential Functions:

• Accountable for ensuring the timely and accurate filing of the Company’s new license applications and renewal of the Company’s existing licenses, including certificates of authority, third-party administrator, and utilization review licenses
• Manage CareSource’s licensing tracking software to ensure filings are made timely and that a record is kept of all materials filed with government agencies
• Proactively create workflows to enhance the Company’s licensing processes
• Coordinate with business owners to gather documents and information in support of license filings
• Provide support to the organization and teammates in assessing, interpreting, and incorporating new and revised regulatory and government contract requirements
• Stay up to date with federal/state laws and regulations, industry standards, and best practices regarding the Company’s licenses
• Report key statistics and trends regarding the licensing process
• Educate other Company staff and leaders regarding license filing requirements, especially renewals, so deliverables are properly tracked and expectations for the responsible areas are set.
• Establish effective working relationships and build and maintain creditability within the organization to support a culture of compliance based on the Company's core values
• Report potential risks, non-compliance, or alleged violations to the Deputy General Counsel or Corporate Compliance Officer
• Identify performance improvement opportunities
• Potentially manage and/or oversee other staff performing licensing functions
• Perform any other job duties as requested

Education and Experience:

• Bachelor’s degree or equivalent years of relevant work experience is required
• A minimum of 5 years of experience in a healthcare related field or other highly regulated industry is required
• Previous management experience is preferred
• Process improvement or audit experience is preferred
• Experience filing license applications and renewals for health maintenance organizations, Life & Health insurers, third party administrators, and/or utilization review organizations, and insurance holding company filings is strongly preferred

Competencies, Knowledge and Skills:

• Adaptable and can drive for results
• Strong client service and teamwork skills
• Excellent time/project management and prioritization skills
• Ability to excel in a dynamic, fast-paced, environment
• Knowledge of standards or controls management, preferably from a Managed Care Organization
• Knowledge of regulatory environment and ability to interpret regulations
• Working knowledge of health plan environment
• Strong analytical and statistical skills and attention to detail
• Ability to work in a fast-past environment and reprioritize
• Effective problem-solving skills with attention to detail
• Strong communication skills, including high-level writing and editing skills, and the ability to speak publicly
• Strong interpersonal skills, a high level of professionalism and the ability to establish effective working relationships with key business partners
• Proficient in Microsoft Word, Excel, and PowerPoint

Licensure and Certification:

• None

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time

Compensation Range:

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. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Organization Level Competencies

• Create an Inclusive Environment

• Cultivate Partnerships

• Develop Self and Others

• Drive Execution

• Influence Others

• Pursue Personal Excellence

• Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.