Director, Operations & Strategic Initiatives

We're building a world of health around every individual , shaping a more connected, convenient and compassionate health experience.

The Director, Operations & Strategic Initiatives plays a key role in advancing the Florida Medicaid health plan's priorities by leading complex initiatives that improve operational performance, member outcomes, quality, and the overall experience for members and providers.

Key Responsibilities

• Partner closely with plan leaders to develop strategy and drive outcomes
• Coordinate across shared services partners in Clinical, Quality, Operations, Network, Finance, Compliance, Claims, Member Services, and IT
• Drive alignment, solve business challenges, and support successful implementation of organisational priorities
• Oversee a portfolio of cross-functional initiatives, manage competing priorities, and ensure the health plan remains responsive to evolving Florida Medicaid requirements, regulatory changes, and business needs
• Lead the execution of strategic and operational initiatives on behalf of the Florida Medicaid health plan, ensuring alignment with organisational priorities and business objectives
• Lead vendor strategy, governance, and performance to maximise value, strengthen accountability, and ensure alignment with Florida Medicaid regulatory, operational, and member needs
• Translate strategic goals into actionable implementation plans with clear milestones, accountability, and measurable outcomes
• Direct and coordinate multiple large-scale, cross-functional projects and transformation efforts simultaneously
• Represent the Florida Medicaid health plan on enterprise initiatives that require Florida-specific activities
• Drive organisational readiness and implementation activities related to Medicaid policy changes, state and federal regulations, contractual requirements, system implementations, and operational enhancements
• Collaborate with health plan leaders to define the deliverables needed from shared services partners including Clinical, Quality, and Population Health teams for health plan implementations focused on behavioural health, chronic disease management, preventive care, maternal health, and LTSS
• Monitor and evaluate program outcomes using key performance indicators, including HEDIS, CAHPS, quality measures, access standards, operational metrics, and population health outcomes
• Ensure initiatives support compliance with contractual requirements while maintaining operational excellence
• Build and maintain strong relationships with providers, community organisations, vendors, and state stakeholders to support strategic objectives and successful program implementation

Required Qualifications

• 10+ years of managed care experience, with a strong understanding of healthcare operations, business processes, and industry trends
• Demonstrated experience collaborating and partnering with cross-functional stakeholders, including senior leaders, business partners, and operational teams to drive strategic initiatives
• Strong relationship management skills with the ability to influence, build trust, and foster alignment across diverse stakeholder groups
• Proven experience developing executive-level presentations and presentation materials, including creating compelling PowerPoint decks and facilitating discussions with senior leadership
• Solid project management experience, including leading complex initiatives, managing multiple priorities, and ensuring successful delivery of business objectives
• 3 years of analysing and problem-solving skills, with the ability to synthesise complex data, identify trends, and develop actionable recommendations
• Experience leveraging data to tell a compelling business story, translating insights into strategic recommendations that support decision-making and drive measurable outcomes
• Demonstrated ability to support and influence business decisions through data analysis, reporting, and performance measurement
• Excellent verbal and written communication skills, with the ability to present complex information clearly to executive and non-technical audiences
• Willingness and ability to travel 10-20% as needed for business meetings, stakeholder engagement, and project support

Preferred Qualifications

• Master's degree (MBA, MHA, MPH, or related field)
• PMP and/or Lean Six Sigma certification
• Florida Medicaid managed care experience
• Experience with Medicaid procurements, readiness reviews, and state implementations
• Experience leading population health and quality improvement initiatives

Pay Range

The typical pay range for this role is: $100,000.00 - $231,540.00

Benefits

This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.