Operations Implementations & Integrations Director(Managed Care Experience Required)

Job Summary:

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:

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 addition to base compensation, you may qualify for a bonus tied to company and individual performance. 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.