What are the responsibilities and job description for the Director Commercial Programs position at McLaren Health Care?
McLaren Health Plan (MHP) is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives. We are looking for a Director, Commercial Programs, to join in leading the organization forward.
MHP is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP offers multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA).
MHP values the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plan can thrive. As an employee of MHP, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members.
Learn more about McLaren Health Plan at https://www.mclarenhealthplan.org
Position Summary:
The Director of Commercial Programs is responsible for the operational leadership, regulatory oversight, and strategic performance of the organization’s commercial and employer-sponsored plan offerings, including administrative services provided to employer groups where the organization serves as a Third-Party Administrator (TPA). This role ensures the effective execution of commercial line-of-business strategy, regulatory compliance, operational performance, employer client satisfaction, and cross-functional program integration across the organization. The Director serves as the internal subject matter expert and operational leader for commercial products and employer-sponsored plan operations, aligning business processes across departments including product development, sales, network management, claims, customer service, compliance, and finance. This role is responsible for the unique regulatory, employer client, and competitive market dynamics of the commercial health insurance environment. The Director will ensure that programs operate efficiently, meet regulatory and contractual requirements, and deliver strong performance in member experience, employer client satisfaction, and financial outcomes.
This is a hybrid position with requirements to come onsite as scheduled, Flint, MI.
Required:
MHP is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP offers multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA).
MHP values the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plan can thrive. As an employee of MHP, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members.
Learn more about McLaren Health Plan at https://www.mclarenhealthplan.org
Position Summary:
The Director of Commercial Programs is responsible for the operational leadership, regulatory oversight, and strategic performance of the organization’s commercial and employer-sponsored plan offerings, including administrative services provided to employer groups where the organization serves as a Third-Party Administrator (TPA). This role ensures the effective execution of commercial line-of-business strategy, regulatory compliance, operational performance, employer client satisfaction, and cross-functional program integration across the organization. The Director serves as the internal subject matter expert and operational leader for commercial products and employer-sponsored plan operations, aligning business processes across departments including product development, sales, network management, claims, customer service, compliance, and finance. This role is responsible for the unique regulatory, employer client, and competitive market dynamics of the commercial health insurance environment. The Director will ensure that programs operate efficiently, meet regulatory and contractual requirements, and deliver strong performance in member experience, employer client satisfaction, and financial outcomes.
This is a hybrid position with requirements to come onsite as scheduled, Flint, MI.
Required:
- Bachelor's degree in Healthcare Administration, Business Administration, Public Health, or a related field; or Associate degree and two (2) years’ job related experience.
- Five (5) years of experience in health plan operations, managed care, or health insurance program administration with demonstrated experience in commercial health insurance operations, employer-sponsored health plans, and/or TPA services and including three (3) years’ experience in a leadership role with direct reports leading or assisting in all phases of effective supervision (i.e., recruitment, performance management, training).
- Two (2) years of experience working with ACA marketplace requirements and regulatory frameworks.
- Experience working in the state of Michigan.
- Schedule: Full-time
- Requisition ID: 26001579
- Daily Work Times: 8:30 am - 5:00 pm
- Hours Per Pay Period: 80
- On Call: No
- Weekends: No