Operations Manager
The Operations Manager for our Care Management Product is responsible for leading our clinical team and optimizing clinical and financial outcomes using clinical experience and following best practice standards and company policies and processes.
Responsibilities
Including, but not limited to:
General Operations
- Create and maintain all operations policies, processes and reports
- Assist in the development of operations key indicators and quality assurance measures and monitor and report performance at established intervals
- Analyze key indicators and quality assurance data to identify opportunities to improve workflow and overall operations performance
- Establish a strong customer service focus across the department
- Ensure on-time completion of patient reports, quarterly and annual customer reports, and special reporting requirements
- Implement product cross-selling within all operations workflows; assure staff is trained and cross-selling on every case
- Ensure compliance with HIPAA and any federal and state regulations governing Personal Health Information
Staff Management
- Establish and maintain appropriate staffing levels to meet customer needs and performance/quality targets
- Create, implement and manage staff and consultant training program
- Assist with recruitment, credentialing and training of qualified operations personnel and consultants
- Manage direct reports and consultants
- Provide regular performance feedback verbally and in writing
- Regularly communicate to the Operations team the company's vision, mission, key initiatives, and performance
- Develop staffing and cost models for presentation by Sales to clients
Inter-Department Coordination, Coordinate with the following departments
- Product Development to implement new products and product enhancements
- Sales and Marketing to meet customer needs and promptly resolve customer service issues
- IT to develop, test, implement, and modify operations systems and reports
- Finance and Accounting to assist with forecasting and monitor Operations budget and invoicing
Qualifications
Education and Certifications
- Bachelors or higher degree in a health related field and licensure as a health professional (where such licensure is available); and
- Active, unrestricted nursing license in the state in which you reside and three (3) years of clinical practice experience in high risk OB, neonatal/NICU, and/or pediatrics; and
- Completion of state-mandated education programs, as required by state license
- CCM and/or ACM Certification Preferred
Experience
- 3 years of operations management experience in health care with proven management and leadership skills
- Extensive case management experience, specifically in the areas of high risk obstetrics, neonatal/NICU, and pediatrics
- ERISA, state Medicaid, and healthcare insurance law knowledge highly desirable
- Experience in developing relationships and working with consultants and clinical personnel, including physicians and nurses helpful
- Experience in a managed care environment, large case management company, third party administrator, utilization review/pre-certification, or other managed care programs
- Experience in start-up environments or scaling company operations to meet aggressive customer acquisition targets
Skills
- Strong analytical, planning, problem-solving, and decision-making skills
- Awareness of Process Improvement Techniques, including Six Sigma and Transactional Lean helpful
- Strong computer skills, specifically Microsoft Office applications
