Workers Compensation ClaimsPosted 3 weeks ago

Senior Vice President - Managed Care

Workers Compensation ClaimsPosted 3 weeks ago

$175,000–$250,000 year

RemoteSouth Carolina, United States

South Carolina, United StatesRemoteFull Time$175,000–$250,000 yearSenior LevelBachelors Degree

Full TimeSenior LevelBachelors Degree

Job Summary

Develop and execute the strategic vision for the Managed Care division, overseeing Medical Management, Bill Review, Pharmacy Benefit Management, and Ancillary Services. Establish and monitor key performance indicators, analyze operational and financial performance to identify revenue growth and efficiency opportunities, and lead organizational planning, budgeting, and resource allocation. Build and mentor high-performing leadership teams while negotiating vendor agreements and ensuring compliance with federal, state, and industry regulations. Partner with Sales, Finance, and Operations to support client retention, delivering presentations to prospects, the Board, and executive leadership. Occasionally travel 10–20% for client meetings and industry conferences.

Required Qualifications

Bachelor's degree
15 or more years of progressively responsible leadership experience
Proven track record of improving operations, increasing revenue, managing budgets, and effectively leading a $30-60M business
Progressive experience in insurance services, managed care, or related business sector
Strong knowledge of statutory regulations, managed care services, vendor management, contract negotiation, and customer service delivery
Experience overseeing direct and indirect reports, including remote teams
Ability to manage a full suite of services for customers, including ongoing maintenance and issue resolution
Exceptional written and verbal communication skills
Experience presenting to C-suite audiences, Boards of Directors, prospects, clients, and industry conference participants
Ability to lift 10 pounds occasionally
Ability to lift 10 pounds frequently
Ability to lift a negligible amount of force constantly
Far vision: clarity of vision at 20 feet or more
Near vision: clarity of vision at 20 inches or less
Mid-range vision: clarity of vision at distances of more than 20 inches and less than 20 feet
Depth perception: the ability to judge distance and space relationships
Color vision: ability to identify and distinguish colors
Field of vision: ability to observe an area up or down or to the right or left while eyes are fixed on a given point
Ability to climb
Ability to balance
Ability to stoop
Ability to kneel
Ability to crouch
Ability to crawl
Ability to reach
Ability to stand
Ability to walk
Ability to push
Ability to pull
Ability to carry
Ability to lift
Ability to move objects
Ability to sit
Ability to walk and stand occasionally
Ability to walk and stand frequently
Ability to walk and stand constantly
Ability to use arm and/or leg controls
Ability to use feet and legs and/or hands and arms
Ability to maintain body equilibrium
Ability to bend body downward and forward
Ability to bend legs at knee
Ability to bend the body downward and forward by bending legs and spine
Ability to move about on hands and knees or hands and feet
Ability to extend hand(s) and arm(s)
Ability to maintain body equilibrium to prevent falling
Ability to judge distance and space relationships
Ability to observe an area up or down or to the right or left
Ability to identify and distinguish colors
Ability to see objects where and as they actually are
Ability to follow one- or two-step instructions
Ability to carry out detail but uninvolved written or verbal instructions
Ability to deal with a few concrete variables
Ability to follow written, verbal, or diagrammatic instructions
Ability to follow several concrete variables
Ability to solve practical problems
Ability to comprehend most obscure concepts
Ability to interpret instructions
Ability to use logical or scientific thinking to solve problems
Ability to use several abstract and concrete variables
Ability to use arithmetic calculations involving fractions, decimals, and percentages
Ability to use arithmetic, algebraic, and geometric calculations
Ability to use advanced mathematical and statistical techniques
Ability to use highly complex mathematical and statistical techniques
Ability to use theoretical application
Ability to understand and follow verbal or demonstrated instructions
Ability to write identifying information
Ability to request supplies verbally or in writing
Ability to file, post, and mail materials
Ability to copy data from one record to another
Ability to interview to obtain basic information
Ability to guide people and provide basic direction
Ability to transcribe dictation
Ability to make appointments and process mail
Ability to write form letters or routine correspondence
Ability to interpret written work instructions
Ability to interview job applicants
Ability to compose original correspondence
Ability to follow technical manuals
Ability to have increased contact with people
Ability to report, write, or edit articles for publication
Ability to prepare deeds, contracts or leases
Ability to prepare and deliver lectures
Ability to interview, counsel, or advise people
Ability to evaluate technical data
Ability to add, subtract, multiply, and divide whole numbers
Ability to perform simple additional and subtraction
Ability to copy figures, counting, and recording
Ability to perform arithmetic calculations involving fractions, decimals, and percentages
Ability to perform arithmetic, algebraic, and geometric calculations
Ability to perform advanced mathematical and statistical techniques
Ability to perform highly complex mathematical and statistical techniques
Ability to perform theoretical application
Ability to understand and follow verbal or demonstrated instructions
Ability to write identifying information
Ability to request supplies verbally or in writing
Ability to file, post, and mail materials
Ability to copy data from one record to another
Ability to interview to obtain basic information
Ability to guide people and provide basic direction
Ability to transcribe dictation
Ability to make appointments and process mail
Ability to write form letters or routine correspondence
Ability to interpret written work instructions
Ability to interview job applicants
Ability to compose original correspondence
Ability to follow technical manuals
Ability to have increased contact with people
Ability to report, write, or edit articles for publication
Ability to prepare deeds, contracts or leases
Ability to prepare and deliver lectures
Ability to interview, counsel, or advise people
Ability to evaluate technical data
Ability to add, subtract, multiply, and divide whole numbers
Ability to perform simple additional and subtraction
Ability to copy figures, counting, and recording
Ability to perform arithmetic calculations involving fractions, decimals, and percentages
Ability to perform arithmetic, algebraic, and geometric calculations
Ability to perform advanced mathematical and statistical techniques
Ability to perform highly complex mathematical and statistical techniques
Ability to perform theoretical application
Ability to understand and follow verbal or demonstrated instructions
Ability to write identifying information
Ability to request supplies verbally or in writing
Ability to file, post, and mail materials
Ability to copy data from one record to another
Ability to interview to obtain basic information
Ability to guide people and provide basic direction
Ability to transcribe dictation
Ability to make appointments and process mail
Ability to write form letters or routine correspondence
Ability to interpret written work instructions
Ability to interview job applicants
Ability to compose original correspondence
Ability to follow technical manuals
Ability to have increased contact with people
Ability to report, write, or edit articles for publication
Ability to prepare deeds, contracts or leases
Ability to prepare and deliver lectures
Ability to interview, counsel, or advise people
Ability to evaluate technical data
Ability to add, subtract, multiply, and divide whole numbers
Ability to perform simple additional and subtraction
Ability to copy figures, counting, and recording
Ability to perform arithmetic calculations involving fractions, decimals, and percentages
Ability to perform arithmetic, algebraic, and geometric calculations
Ability to perform advanced mathematical and statistical techniques
Ability to perform highly complex mathematical and statistical techniques
Ability to perform theoretical application
Ability to understand and follow verbal or demonstrated instructions
Ability to write identifying information
Ability to request supplies verbally or in writing
Ability to file, post, and mail materials
Ability to copy data from one record to another
Ability to interview to obtain basic information
Ability to guide people and provide basic direction
Ability to transcribe dictation
Ability to make appointments and process mail
Ability to write form letters or routine correspondence
Ability to interpret written work instructions
Ability to interview job applicants
Ability to compose original correspondence
Ability to follow technical manuals
Ability to have increased contact with people
Ability to report, write, or edit articles for publication
Ability to prepare deeds, contracts or leases
Ability to prepare and deliver lectures
Ability to interview, counsel, or advise people
Ability to evaluate technical data
Ability to add, subtract, multiply, and divide whole numbers
Ability to perform simple additional and subtraction
Ability to copy figures, counting, and recording
Ability to perform arithmetic calculations involving fractions, decimals, and percentages
Ability to perform arithmetic, algebraic, and geometric calculations
Ability to perform advanced mathematical and statistical techniques
Ability to perform highly complex mathematical and statistical techniques
Ability to perform theoretical application
Ability to understand and follow verbal or demonstrated instructions
Ability to write identifying information
Ability to request supplies verbally or in writing
Ability to file, post, and mail materials
Ability to copy data from one record to another
Ability to interview to obtain basic information
Ability to guide people and provide basic direction
Ability to transcribe dictation
Ability to make appointments and process mail
Ability to write form letters or routine correspondence
Ability to interpret written work instructions
Ability to interview job applicants
Ability to compose original correspondence
Ability to follow technical manuals
Ability to have increased contact with people
Ability to report, write, or edit articles for publication
Ability to prepare deeds, contracts or leases
Ability to prepare and deliver lectures
Ability to interview, counsel, or advise people
Ability to evaluate technical data
Ability to add, subtract, multiply, and divide whole numbers
Ability to perform simple additional and subtraction
Ability to copy figures, counting, and recording
Ability to perform arithmetic calculations involving fractions, decimals, and percentages
Ability to perform arithmetic, algebraic, and geometric calculations
Ability to perform advanced mathematical and statistical techniques
Ability to perform highly complex mathematical and statistical techniques
Ability to perform theoretical application
Ability to understand and follow verbal or demonstrated instructions
Ability to write identifying information
Ability to request supplies verbally or in writing
Ability to file, post, and mail materials
Ability to copy data from one record to another
Ability to interview to obtain basic information
Ability to guide people and provide basic direction
Ability to transcribe dictation
Ability to make appointments and process mail
Ability to write form letters or routine correspondence
Ability to interpret written work instructions
Ability to interview job applicants
Ability to compose original correspondence
Ability to follow technical manuals
Ability to have increased contact with people
Ability to report, write, or edit articles for publication
Ability to prepare deeds, contracts or leases
Ability to prepare and deliver lectures
Ability to interview, counsel, or advise people
Ability to evaluate technical data
Ability to add, subtract, multiply, and divide whole numbers
Ability to perform simple additional and subtraction
Ability to copy figures, counting, and recording
Ability to perform arithmetic calculations involving fractions, decimals, and percentages
Ability to perform arithmetic, algebraic, and geometric calculations
Ability to perform advanced mathematical and statistical techniques
Ability to perform highly complex mathematical and statistical techniques
Ability to perform theoretical application
Ability to understand and follow verbal or demonstrated instructions
Ability to write identifying information
Ability to request supplies verbally or in writing
Ability to file, post, and mail materials
Ability to copy data from one record to another
Ability to interview to obtain basic information
Ability to guide people and provide basic direction
Ability to transcribe dictation
Ability to make appointments and process mail
Ability to write form letters or routine correspondence
Ability to interpret written work instructions
Ability to interview job applicants
Ability to compose original correspondence
Ability to follow technical manuals
Ability to have increased contact with people
Ability to report, write, or edit articles for publication
Ability to prepare deeds, contracts or leases
Ability to prepare and deliver lectures
Ability to interview, counsel, or advise people
Ability to evaluate technical data
Ability to add, subtract, multiply, and divide whole numbers
Ability to perform simple additional and subtraction
Ability to copy figures, counting, and recording
Ability to perform arithmetic calculations involving fractions, decimals, and percentages
Ability to perform arithmetic, algebraic, and geometric calculations
Ability to perform advanced mathematical and statistical techniques
Ability to perform highly complex mathematical and statistical techniques
Ability to perform theoretical application
Ability to understand and follow verbal or demonstrated instructions
Ability to write identifying information
Ability to request supplies verbally or in writing
Ability to file, post, and mail materials
Ability to copy data from one record to another
Ability to interview to obtain basic information
Ability to guide people and provide basic direction
Ability to transcribe dictation
Ability to make appointments and process mail
Ability to write form letters or routine correspondence
Ability to interpret written work instructions
Ability to interview job applicants
Ability to compose original correspondence
Ability to follow technical manuals
Ability to have increased contact with people
Ability to report, write, or edit articles for publication
Ability to prepare deeds, contracts or leases
Ability to prepare and deliver lectures
Ability to interview, counsel, or advise people
Ability to evaluate technical data
Ability to add, subtract, multiply, and divide whole numbers
Ability to perform simple additional and subtraction
Ability to copy figures, counting, and recording
Ability to perform arithmetic calculations involving fractions, decimals, and percentages
Ability to perform arithmetic, algebraic, and geometric calculations
Ability to perform advanced mathematical and statistical techniques
Ability to perform highly complex mathematical and statistical techniques
Ability to perform theoretical application
Ability to understand and follow verbal or demonstrated instructions
Ability to write identifying information
Ability to request supplies verbally or in writing
Ability to file, post, and mail materials
Ability to copy data from one record to another
Ability to interview to obtain basic information
Ability to guide people and provide basic direction
Ability to transcribe dictation
Ability to make appointments and process mail
Ability to write form letters or routine correspondence
Ability to interpret written work instructions
Ability to interview job applicants
Ability to compose original correspondence
Ability to follow technical manuals
Ability to have increased contact with people
Ability to report, write, or edit articles for publication
Ability to prepare deeds, contracts or leases
Ability to prepare and deliver lectures
Ability to interview, counsel, or advise people
Ability to evaluate technical data
Ability to add, subtract, multiply, and divide whole numbers
Ability to perform simple additional and subtraction
Ability to copy figures, counting, and recording
Ability to perform arithmetic calculations involving fractions, decimals, and percentages
Ability to perform arithmetic, algebraic, and geometric calculations
Ability to perform advanced mathematical and statistical techniques
Ability to perform highly complex mathematical and statistical techniques
Ability to perform theoretical application
Ability to understand and follow verbal or demonstrated instructions
Ability to write identifying information
Ability to request supplies verbally or in writing
Ability to file, post, and mail materials
Ability to copy data from one record to another
Ability to interview to obtain basic information
Ability to guide people and provide basic direction
Ability to transcribe dictation
Ability to make appointments and process mail
Ability to write form letters or routine correspondence
Ability to interpret written work instructions
Ability to interview job applicants
Ability to compose original correspondence
Ability to follow technical manuals
Ability to have increased contact with people
Ability to report, write, or edit articles for publication
Ability to prepare deeds, contracts or leases
Ability to prepare and deliver lectures
Ability to interview, counsel, or advise people
Ability to evaluate technical data
Ability to add, subtract, multiply, and divide whole numbers
Ability to perform simple additional and subtraction
Ability to copy figures, counting, and recording
Ability to perform arithmetic calculations involving fractions, decimals, and percentages
Ability to perform arithmetic, algebraic, and geometric calculations
Ability to perform advanced mathematical and statistical techniques
Ability to perform highly complex mathematical and statistical techniques

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