Contact info: (866) 371-0687, info@mmsgrouponline.com

Sr. Director, Business Operations- MCO

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Location
AUSTIN, TX
Job Type
Direct Hire
Degree
Bachelor
Date
Feb 08, 2019
Job ID
2653687
Sr. Director, Business Operations- MCO- Austin, TX

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Excellent opportunity to make a direct impact on the success of this international healthcare enterprise by driving quality and process improvement and developing an exceptional team.


 
     Generous relocation- UNLIMITED career growth locally & nationally


Oversight for operations programs in multiple service areas including billing and enrollment, call center, customer service, etc. and related initiatives that impact membership for product lines and health plans, to include provider data management and credentialing.


Responsible for identification of business need, strategy recommendation, project outline, management of deliverables, and ROI


Direct the identification, development, and implementation programs centered on quality and operations excellence


Develop and monitor service levels to ensure compliance with state, federal, and company metrics and standards


Work collaboratively to facilitate the design, development and implementation of policies, procedures and practices related to service operations


Establish and maintain working relationships with external sources such as CMS for regulatory and compliance guidance


Develop and maintain collaborative relationships with health plans, other business units, IT partners, and oversee training and business processes as necessary


Direct and oversee continuous improvement of multiple systems for critical operations to enable business objectives


Direct and oversee health insurance service levels; identify service opportunities, new business implementations and product expansions.

Responsible for multiple systems from a business owner standpoint for all membership and channel management services.




 QUALIFICATIONS -


Bachelor’s degree in Business or related field.


10+ years of business operations and systems integration experience for call center, enrollment, billing, payment processing, or similar operations applications.


Previous leadership experience including responsibilities for hiring, training, assigning work and managing performance of staff.


Experience with provider data management and credentialing.


Health insurance and program management experience


Experience working with configuration and claims.


Root cause analysis with the ability to communicate with technical counterparts. Strong analytics experience.


Preferred Qualifications:


Advanced knowledge of PDM (Provider Data Management) and Credentialing.


Highly refined oral and written communication experience including the ability to build strong business relationships across the enterprise


Demonstrated experience performing advance analytics leveraging MS Excel


Strong knowledge of Medicaid and government programs