Position plans and directs activities for the business function (or multiple functions) within Operations, including internal and/or external. Process improvement and project management are key aspects of this position. Assignments are broad in nature, usually requiring considerable creativity, originality and ingenuity.
REPORTS TO: DIRECTOR, CUSTOMER SERVICE
DEPARTMENT: OPERATIONS-NASHVILLE CALL CENTER
POSITION LOCATION: NASHVILLE, TN 37211
- Develops and directs the implementation of strategies to substantially improve efficiencies and service provided while reducing costs.
- Facilitates the development and implementation of goals and performance standards.
- Manages processes and projects that are aligned directly to operational goals and budgets.
- Works closely with the appropriate parties to implement high level quality and performance management initiatives.
- Manages and develops direct reports who include other management or supervisory personnel and/or exempt individual contributors.
- Plans, conducts and directs work on complex projects/programs necessitating the origination and application of new and unique approaches.
- Ensures corporate initiatives are implemented to achieve optimum results.
- Establishes objectives, schedules, and cost data of business function being managed.
- Applies a comprehensive knowledge of a particular field of specialization to the completion of assignments.
- Advises management in long-range planning for areas of specialization.
- Provides technical direction to functional supervisors, managers and other management.
- Directs, develops and implements appropriate changes in area(s) policy and procedures under the guidance of the Directors of Operations.
- Sets integration priorities, develops growth strategies, and manages resources for new business opportunities.
- Has an understanding of compliance activities and can interpret and apply regulatory requirements to an operating unit
- Responsible for managing and oversight of training and reference materials including content, work instructions, and tools necessary for associate consumption
- Serves as primary contact for compliance and audit related activities. Ensure compliance issues are tracked and resolved
- Manage process improvement initiatives
- Other Duties As Assigned
- Bachelor's Degree in business or equivalent directly related to experience is preferred
- MBA or equivalent directly related to experience is preferred
- 7 years of experience in a related field based on Operational areas is required
- 3 years of experience in progressively responsible management is required
- Experience in the related area of Operations at management level is required
- Compliance, Regulatory and Audit Experience is preferred
- Demonstrated leadership skills
- Ability to lead/manage others
- Demonstrated analytical skills
- Demonstrated interpersonal/verbal communication skills
- Ability to communicate and make recommendations to upper management
- In-Depth functional knowledge and broad multi-functional knowledge
- Understanding of managed care and its place in the health care industry
- Understanding of interrelationships between Call Center, Health Services, Provider Relations, Sales, Vendors, and Claims and their impact on the success of the health plan as a whole
- Knowledge of modern call center systems and ability to utilize them to their maximum potential
- Knowledge of call center planning and the ability to create and implement a capacity plan that meets goals