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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.
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
Additional Responsibilities:Candidate Education:
Preferred A Bachelor's Degree in business or equivalent directly related to experience
Preferred Other MBA or equivalent
Required 7 years of experience in a related field based on Operational areas
Required 3 years of experience in progressively responsible management
Required Other Strong experience in the related area of Operations at management level
Preferred Other Compliance, Regulatory and Audit Experience
Intermediate Demonstrated leadership skills
Intermediate Ability to lead/manage others
Intermediate Demonstrated analytical skills
Intermediate Demonstrated interpersonal/verbal communication skills
Intermediate Ability to communicate and make recommendations to upper management
Intermediate Other In-Depth functional knowledge and broad multi-functional knowledge
Advanced Other Solid understanding of managed care and its place in the health care industry
Advanced Other Strong 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
Advanced Other Strong knowledge of modern call center systems and ability to utilize them to their maximum potential
Advanced Other Strong knowledge of call center planning and the ability to create and implement a capacity plan that meets goals
Licenses and Certifications: A license in one of the following is required: Technical Skills:Languages: