Health Insurance Operations Director jobs in Hamden, CT

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)

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Clinical Operations Director
  • Nema Health
  • Branford, CT FULL_TIME
  • Job Description: Clinical Operations Director

    Nema Health is a survivor and clinician led virtual center for PTSD & trauma care. Our mission is to guide trauma survivors at every step of their journey towards healing, starting first with the remote, intensive delivery of cognitive processing therapy (CPT). 

    Nema is seeking a Clinical Operations Director who will be the backbone of Nema’s care program success as Nema looks to grow and scale with quality. The Clinical Operations Director will report to the COO, and work closely with the Chief Medical Officer, Clinical Director, Head of Product, and Operations team. This person will manage Practice Coordinators, Peer Navigators, Admissions Managers, and Billers. 

    At Nema Health, we offer employees an unparalleled career opportunity: each team member can focus on Nema’s mission-driven goal while influencing the shape of the business in its early stages. If you thrive from being execution-oriented, enjoy thinking on the systems-level, bring creativity in building, and are passionate about helping trauma survivors, we invite you to apply.

    Responsibilities:

    Build out the operations to expand footprint 

    • Manage and drive process for obtaining and renewing state licenses for providers using third party resources as needed
    • Work with Nema’s legal team to ensure Nema meets the corporate practice of medicine requirements for each new state the business enters

    Scale the size of the clinic

    • Own the provider recruiting and onboarding process with the goal of creating a differentiated employer brand among therapists
    • Keep a close and quantifiable pulse on the clinical capacity modeling used to determine hiring needs based on patient volume and state footprint
    • In partnership with the Clinical Director, optimize clinical efficiency of clinical team members while balancing the therapist experience
    • Oversee the Admissions function, led by the Admissions Manager, to successfully and efficiently get new patients into care

    Deliver clinical services with quality as we scale 

    • Run point on internal meetings and work streams related to Nema’s “CareOps” system which is rooted in QI practices
    • Collaborate with the clinical team to establish procedures and processes for consistent operations and positive patient/provider experience
    • Monitor key performance indicators (KPIs) related to quality of care, and develop strategies for continuous improvement
    •  Conduct regular audits and assessments to identify areas for improvement and address any deficiencies in Nema’s care program

    Sustain the clinical business financially 

    • Oversee the billing function, ensuring accurate and timely processing of claims in compliance with billing regulations
    • With the billing team, monitor revenue cycle performance and implement strategies to maximize revenue and minimize denials

    Lead the Clinical Operations team 

    • Provide strong leadership and direction to the Clinical Operations team, fostering a culture of accountability, collaboration, and continuous improvement
    • Mentor and develop team members, providing guidance and support to help them reach their full potential
    • Foster effective communication and collaboration across departments to ensure alignment with organizational goals

    Qualifications

    Required 

    • 7 years working in healthcare services with an understanding of the key stakeholders and major trends
    • 5 years in a Clinical Operations role overseeing multiple people or teams and driving operational excellence
    • Affinity for and success in people management, and can inspire and lead teams
    • Strong understanding of healthcare regulations, licensing requirements, and billing practices
    • Highly organized and can work autonomously in an early company environment; has an affinity for managing work streams from start to finish and driving next steps
    • Strong problem solver with a growth mindset; bias towards creating solutions that can scale and increase efficiencies
    • Strong analytical skills and data driven; very comfortable with quantitative analysis
    • Well rounded technical skills including high proficiency with Excel/Google Sheets  and working with datasets and data visualization tools (e.g., Looker) for analysis
    • Comfortable in a fast-paced environment, subject to rapid change and innovation
    • Adept and efficient at navigating new platforms and learning new skills
    • Outstanding interpersonal and communication skills, both written and verbal
    • Passionate about the company’s mission and operates from a company-owner mentality to make Nema successful
    • Ability to travel approximately once a quarter for week long team meet-ups

    Preferred

    • 4 years working in mental healthcare services with familiarity of the trends in the behavioral health space
    • 2 years at an early stage startup (pre seed to series A for example)
    • Clinical experience and ability to connect with clinical teams
    • Demonstrated experience in building out Clinical Operations functions
    • Experience with EHRs and/or CRMs

     


    Nema Health is a seed stage company backed by top healthcare VCs. This is a full time, exempt, salaried position reporting to the COO. Compensation will be determined by the candidate's experience, with a base salary range of $125,000-$150,000. The full-time compensation package will include competitive equity, unlimited PTO, a healthcare stipend, a 401(k) with matching, an annual work-from-home productivity stipend, an annual education stipend, and paid parental leave. This role is remote and the candidate can be located anywhere in the United States.



  • 8 Days Ago

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Director, HR Operations
  • Clifford Beers Community Health Partners
  • New Haven, CT FULL_TIME
  • Organizational Summary Clifford Beers Community Health Partners (CBCHP) is a 501(3)(c) organization and is the parent company for three affiliate nonprofits. These three affiliates include: Youth Cont...
  • 23 Days Ago

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Director of Finance and Operations
  • Lost in New Haven, Inc.
  • New Haven, CT FULL_TIME
  • Lost in New Haven, Inc. (LOST) is a dynamic new history museum, cultural center and event space that fosters community learning and engagement by providing a space at the intersection of art, history ...
  • Just Posted

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Associate Director of Development Operations
  • Hole in the Wall Gang
  • New Haven, CT FULL_TIME
  • Full-time Hybrid Organization Description: Founded in 1988 by Paul Newman, The Hole in the Wall Gang Camp provides “a different kind of healing” to thousands of children with serious illnesses and the...
  • 12 Days Ago

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Assistant Director for Residential Operations
  • University of New Haven
  • West Haven, CT FULL_TIME
  • Who we are: The University of New Haven, founded on the Yale campus in 1920, is a private, coeducational university that has been recognized by The Princeton Review and U.S. News & World Report for ac...
  • 13 Days Ago

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Director, Clinical Operations
  • Bausch + Lomb
  • New Haven, CT FULL_TIME
  • Bausch Lomb (NYSE/TSX: BLCO) is a leading global eye health company dedicated to protecting and enhancing the gift of sight for millions of people around the worldfrom the moment of birth through ever...
  • 1 Month Ago

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0 Health Insurance Operations Director jobs found in Hamden, CT area

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Senior Manager, Corporate Insurance
  • Linde
  • Danbury, CT
  • As a Linde Insurance Manager, you will work to provide financial mitigation to Linde and its Directors for losses incurr...
  • 4/25/2024 12:00:00 AM

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Loss Control Specialist II (NY)
  • AmTrust Financial Services, Inc.
  • Rocky Hill, CT
  • Overview: SUMMARY: Multi-line field position with primary responsibilities of conducting physical Underwriting Loss Cont...
  • 4/25/2024 12:00:00 AM

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Senior Claims Representative
  • Integris Group
  • Glastonbury, CT
  • Work for a company that values you Integris Group is a medical professional liability insurance carrier. We put our tale...
  • 4/25/2024 12:00:00 AM

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Claims Associate
  • Integris Group
  • Glastonbury, CT
  • Work for a company that values you! Integris Group is a medical professional liability insurance carrier. We put our tal...
  • 4/24/2024 12:00:00 AM

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Claims Representative
  • Integris Group
  • Glastonbury, CT
  • Work for a company that values you! Integris Group is a medical professional liability insurance carrier. We put our tal...
  • 4/24/2024 12:00:00 AM

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Senior Manager, Corporate Insurance
  • Linde
  • Danbury, CT
  • As a Linde Insurance Manager, you will work to provide financial mitigation to Linde and its Directors for losses incurr...
  • 4/22/2024 12:00:00 AM

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Senior Claims Representative
  • Integris Group
  • Glastonbury, CT
  • Work for a company that values you! Integris Group is a medical professional liability insurance carrier. We put our tal...
  • 4/22/2024 12:00:00 AM

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Claims Associate
  • Integris Group
  • Glastonbury, CT
  • Work for a company that values you Integris Group is a medical professional liability insurance carrier. We put our tale...
  • 4/22/2024 12:00:00 AM

Hamden is a town in New Haven County, Connecticut, United States. The town's nickname is "The Land of the Sleeping Giant." The population was 60,960 at the 2010 census. Hamden is a suburb of the city of New Haven. The town of Hamden ranked #53 in the CNN Money list of "America's best small cities" in 2012. In 2008, Fortune Magazine and CNN Money picked Hamden as #33 on their "Best Place to Live and Launch" list, citing Hamden's great blend of urban and suburban lifestyles. The article also pointed out Hamden's exceptional education system as well as its "New England Charm". According to the U...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Health Insurance Operations Director jobs
$186,688 to $251,765
Hamden, Connecticut area prices
were up 1.7% from a year ago