Job Description

Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:

• Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women

• Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR

• Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.

• Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

Skills / Requirements

JOB SUMMARY
As a member of the Executive Leadership team, the Vice President, Information Technology (VP, IT) reports to the Chief Operating Officer (COO) and assumes a strategic role in the overall management of the organization. The VP, IT has primary day-today responsibility for planning, implementing, managing, and controlling all information technology and information systems-related activities of the company. This includes direct responsibility for IT systems/platforms, system configuration, data centers/warehousing, and IT infrastructure. The VP, IT must remain current with health care and managed care insurance technologies and assess their impact on the organization. Closely collaborates with the Information Security Officer and the HIPAA Security Officer to design, implement and maintain appropriate data security measures. This role is responsible for strategic planning and alignment with organizational strategic objectives. Prepares and develops multi-year departmental and organizational budgets including technology implementations, upgrades, administrative expenses, and cost targets. Serves as Community's Information Technology spokesperson to both internal and external customers.

JOB SPECIFICATIONS AND CORE COMPETENCIES
Responsible for strategic oversight and daily management of the IT and infrastructure departments. Ensures appropriate processes Develop and monitor annual information resources operating and capital budgets to ensure that all IT areas of responsibility have the necessary funding to carry out established organizations goals and objectives. Develop and manage appropriate staffing and efficient departmental operations with cost monitoring to stay within annual budget.

Develop annual information technology business plan to achieve goals by prioritizing technology initiatives and coordinating the evaluation, deployment, and management of current and future technologies. Ensure information technology strategies align with overall organization mission and vision. Stay abreast of the latest developments, advances and trends in healthcare and information technology to ensure optimal professional effectiveness and competence.

Provides executive team and with advice and guidance regarding the financial implications of various business activities and initiatives. Evaluates and advises on the impact of long-range planning, introduction of new programs/business strategies and regulatory actions. Provide recommendations to strategically enhance IT/infrastructure performance and business opportunities.

Coordinates closely with Information Security and Compliance to develop, implement, and maintain information security policies and procedures (including HIPAA), ensuring regulatory compliance and appropriate levels of internal controls. Handles organization's and/or members' most sensitive and restricted information, release information only with top management authorization. Establish and maintain a system that fosters the routine use of risk assessments and risk management planning related to information security features of systems, networks, and administrative activities. Monitor assessments, plans, implementations, operations, and usage related to information security throughout the organization.

Manage and approve all information technology requests for the organization. Work with legal, purchasing, and appropriate Harris Health/Harris County functions on all request for proposals, business associate agreements, vendor contracts and personal services agreements. Works with staff to prepare proposals and agreements as necessary and select the appropriate vendor consistent with the policies and procedures of the organization and county purchasing.

Maintain compliance with the Texas Health & Human Services Commission (HHSC) by ensuring that all IT requirements are met. Including all IT related deliverables such as encounter data and others. Serve as CHC's liaison with HHSC and other regulatory bodies related to information technology and security. Stay abreast of current federal and state legislation affecting information technology.

Develop and maintain business continuity and disaster recovery strategy that includes staffing, budgeting and process decisions that support both the long and short-term objectives of the organization.

Responsible for development and achievement of departmental goals, as identified in Department's annual business plan, including specific departmental process improvement plans, and other duties as assigned.


QUALIFICATIONS:
Education/Specialized Training/Licensure: BS/BA Degree in Information Systems, Computer Science, Computer Engineering, or related degree required.

Master's degree in computer science, Healthcare Administration, MBA, or other related degree strongly preferred. 

Work Experience (Years and Area): 10 years direct experience in Information Technology sector. Specific experience in security systems, enterprise applications, electronic data interchange (EDI), X12 HIPAA transactions, web and mobile technologies, Telecommunication Systems, enterprise databases, storage systems, server and desktop virtualization, network infrastructure, disaster recovery and high availability.

Experience managing health plan claims payment systems, CRM systems, and Microsoft platforms required. Experience with QNXT, Power BI, SQL and SAS preferred.

Management Experience (Years and Area): Seven years experience in managing the information technology function, preferrable in Managed Health Care Organization or integrated healthcare delivery system.

Software Proficiencies: Microsoft Office (Word, Excel, Outlook)

Application Instructions

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