Health Insurance Operations Director directs and oversees health insurance operations programs in multiple service areas, including account installation, implementation, client support, contract administration, claim processing, and enrollment and eligibility. Manages vendors assigned to each operation. Being a Health Insurance Operations Director resolves issues within each service area. Has deep knowledge of health insurance operations. Additionally, Health Insurance Operations Director typically requires a bachelor's degree of business administration or its equivalent. Typically reports to top management. The Health Insurance Operations Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. To be a Health Insurance Operations Director typically requires 5+ years of managerial experience. (Copyright 2024 Salary.com)
The Director of Operations oversees the operations of all NOAH multi-specialty FQHC clinics across Maricopa County. They are responsible to lead the Practice Manager at each clinic location who is responsible for primary care, internal medicine, Pediatrics, Psych, Nutrition and coordinating integrated care with other service lines, to include but not limited to Dental and Behavioral Health.
Supervisory Responsibilities:
Recruits, interviews, hires, and lead Practice Management staff.
Trains and mentors Practice Management staff; establishes leadership expectations and defined accountabilities.
Ensures that all policies and procedures are consistently implemented and enforced.
Provides constructive and timely performance evaluations.
Handles discipline and termination of employees in accordance with company policy.
Duties/Responsibilities:
Provides oversight of multi-practice operations ensuring efficiency and alignment with organizational goals.
Ensure proper controls and practices are followed and documented to secure the financial viability of the practice.
In collaboration with Practice Managers, Director of Community Access, and other service line leadership; monitors financial and operational metrics, identifies adverse trends and develops action plans to improve performance.
Continuously monitor service line and clinic specific KPI’s and proactively provide action plans to leadership.
Collaborate with Practice Managers to address operational challenges and implement effective solutions.
Coordinates with the Director of Specialty to ensure efficient integrated care for all Behavioral Health patients.
Responsible for facilitating and/or leading effective communication around all projects to a variety of stakeholders, including Service line provider leadership, program managers, and Executive leaders.
Partners with leadership and providers to ensure high quality patient care and customer service is delivered in the most financially efficient way.
Develops and implements strategic operational initiatives.
Monitors the operations and workflow; revises operational procedures in alignment with system practices.
Prepares and executes budget with practice management and finance team.
Works in conjunction with the compliance, risk, and quality teams; ensures assigned practices meet all licensing, regulatory and accreditation requirements and oversees continuous readiness initiatives.
Works with marketing to build and maintain community partnerships and relationships to attract new customers, retain existing customers and support NOAH’s desired brand positioning.
Attends, participates, and/or assists in meetings, trainings, community outreach activities, continuing education opportunities, and other activities as required.
Performs other related duties as assigned.
Required Skills/Knowledge/Abilities:
Thorough understanding of practices, theories, and policies involved in business and finance.
Superior verbal and written communication and interpersonal skills.
Superior managerial and diplomacy skills.
Extremely proficient in Microsoft Office Suite or related software.
Excellent organizational skills and attention to detail.
Excellent analytical, decision-making, and problem-solving skills.
Education and Experience:
Required:
3 years managing multiple physician practices, or a multi-specialty physician group.
Bachelor’s degree in health care administration, Public Health, Business Administration, or another relevant field.
5 years related/equivalent outpatient medical or physician practice experience in a leadership role.
Preferred:
Master’s degree.
Registered Nurse (RN) or clinical experience such as APP, Medical Assisting, Nursing, or other relevant experience.
1 years FQHC or similar experience serving underserved populations.