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The Director of Operations provides strategic guidance, analytics, and leadership to the Managed Care/Cost Containment operations team while managing the day to day production workflows and processes for all products. Critical interactions may involve technology providers, informatics, internal and external partners or other industry organizations and direct production management of the internal clinical team.
Overall responsibilities include but are not limited to:
- Implements and Owns the strategic plan for the Managed Care/Cost Containment Operations team to ensure the organization meets customer experience needs and achieve best financial results
- Partners with executive leaders to lead the adoption of technology, clinical partners, or workflows that are innovative, interoperable, patient-centric, user friendly, and focused on quality and cost effective outcomes
- Drive innovation and best-practice adoption across the organization as it relates to clinical management program to achieve the best outcomes for claimants served
- Demonstrates the use of tact and discretion in all communications and provide a positive contribution to the morale of the department
- Identify and use data to objectively manage unit performance, plan resource requirements, and make product related decisions
- Champion the redesign of clinical production workflows to support the business in meeting internal and client goals. Automate key processes to realize cost, time, and accuracy and/or quality improvements
- Help establish, monitor and adhere to claim and corporate operations budget
- Develops clinical educational resources that include critical thinking, workflow and care process changes and not just use of the health technology
- Act as key decision maker in determining the process strategies and identifying resources needed to achieve an outstanding outcome
- Ensure that appropriate documentation, implementation and communication of established policy, procedures and operating standards is completed and regularly monitor and evaluate activities to identify potential risks and issues
- Optimize staff performance, development and retention and oversee performance management and complete performance management cycle for direct reports.
- Maintain strict confidentiality of all aspects of the position
- Engage and inspire team members
- Other duties as may be assigned
- Approximately 20% travel required