Network Control Center Director jobs in Pennsylvania

Company :

Job Description : 

GENERAL OVERVIEW:

Directs operational activities for all assigned specialty areas. Serves as the coordinator of all needs/services of the specialty line and addresses concerns/problems through resolution. Provides operational leadership and direction to the service line focusing on positively influencing successful operations. Identifies, plans, organizes, communicates, implements and measures activities and strategies that promote growth, clinical excellence, patient satisfaction, fiscal prudence, enhanced communication, optimal clinical productivity and system success.

ESSENTIAL RESPONSIBILITIES:

• Develops and implements business strategies in conjunction with the Vice President of the respective Service Line in accordance with organizational goals. Maintains an in-depth knowledge of the changing healthcare environment and evaluates the market need for specific clinical services or programs.
• Identifies the need for quality and performance improvement initiatives in accordance with strategic direction. Develops and implements plans for clinical, administrative and safety improvement processes in collaboration with Service Line Vice President, clinical and physician leadership.
• Establishes revenue and expense targets in conjunction with Service Line Vice President; analyzes trends impacting revenue and volume; identifies opportunities to optimize clinical reimbursement and implements new policies and procedures as necessary. Maintains a thorough understanding of clinical reimbursement and managed care issues, specific to the specialty line.
• Provides leadership, management and supervision to directors, managers and supervisors within scope of responsibility, ensuring hiring, development and retention of key personnel. Works closely with the VP Service Line and the Department Chiefs and Chairs in the recruitment and establishment of new physicians in accordance with strategic plans, as needed. Ensures compliance with all government and corporate policies, procedures and regulations.
• Supervises and provides administrative and operational guidance to directors, managers and supervisors who are responsible for daily operations and management of the specialty line. Employs analytical judgment, manages projects, organizes resources, consults and solves problems. Maintains open communications with physicians, staff and management.

QUALIFICATIONS:
Minimum

• Bachelor's degree in healthcare administration, business administration or related field or relevant experience and/or education as determined by the company in lieu of bachelor's degree
• 7-10 years’ practice management experience and/or related practice management consulting/operations experience
• Must have knowledge of financial management, managed care insurance plans, third party billing/reimbursement, and human resources administration
• Strong communication, organizational and follow-up skills required
• Extensive experience in developing business plans and budget management

Preferred

• Master’s degree

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

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