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Responsibilities:

The Director of Contract Performance reports to the Market President and must serve as the primary point of contact on behalf of the State Agency regarding the health plan.; This includes developing and maintaining strong professional relationships with State Agency leadership and ensuring strong contract performance. They must work closely with business and enterprise owners to identify streamlined workflows and processes to operate more efficiently and profitably, define reporting requirements, and initiate projects to improve current state functions that perform below required levels.; A key function of this role is to implement special projects as assigned by the Market President and provide a monthly consolidation of the Plan’s operational performance.; The incumbent will deliver a cross-functional review of key measurements and performance indicators and provide business improvement recommendations.

**Work Arrangements:** Hybrid schedule with a minimum of two days in the Southfield, MI office.;

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Key Responsibilities

+ The Director of Contract Performance is responsible for developing systems and tools to ensure sustainable improvement on key performance metrics.;

+ Responsible for researching, collecting, and confirming key state contract operational measures.;Coordinate with cross-functional leaders and key external stakeholders to ensure workflows and processes meet all contractual and regulatory requirements.

+ Responsible for coordinating and preparing for both planned and ad-hoc onsite or virtual agency visits to discuss the status of the Contract, Health Plan performance, benefits to the State, necessary revisions, reviews, reports, and planning.

+ Responsible for developing and implementing policies and procedures to maximize the efficiency and effectiveness of services required under the contract.

+ Foster open internal communication between Plan and Corporate Shared Services and externally with the agency.

+ Assigns and provides needed oversight to ensure Contract changes are implemented on time.

+ Actively lead contract-related implementation workgroups to include new benefit changes, contractual language amendments, and Agency policy updates to confirm successful contract execution and maintain positive relationship with State departments.

+ Manage state contract deliverable submissions, including but not limited to readiness review and re-procurement materials, member and provider communications, and subcontractor and vendor contract approvals, as required.

+ Coordinate the health plan response to contract audits and ad-hoc data requests.; Includes developing presentations, validating data, and summarizing and communicating contract performance issues received from the agency to relevant stakeholders.

+ Coordinate with key stakeholders to facilitate mitigation strategies to address contract performance issues.

+ Represent the Plan in meetings with internal departments, external government, and community agencies and remain well-versed in operational and state-related activities.;

+ Partner with business owners and corporate reporting areas to standardize processes, develop relevant metrics, and design scorecards highlighting health plan performance in multiple key areas.

+ Participates with the executive management team in the planning necessary to achieve the administration of the day-to-day business activities of the contract with the State.

+ Coordinate with executive staff to develop, communicate, and track annual and three-year strategic/business plan progress.

+ Assist compliance in preparation and execution of health plan audits, including documentation organization, completion of audit forms, and audit reporting.

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Education/Experience:** **;

+ Bachelor’s Degree required or related work experience;

+ ;Master's degree preferred

+ A minimum of five (5) to ten (10 ) years experience in operational and regulatory policy updates, managed care, and contract compliance.

+ Ability to build relationships with key external and internal stakeholders.

+ A minimum of five (5) years of government experience with managed care knowledge.

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At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

As a company, we support internal diversity through:

Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.