Description and Requirements
The Senior Manager, Medical Operations will manage the office of the Vice President, Senior Medical Director (VPSMD): supporting the VPSMD to set agendas for selected internal meetings; prioritize among competing enterprise and departmental needs; develop business plans and strategies that support the Clinical Operations and Medical organizations meet short and long-term objectives; help manage key performance indicators and measure team performance; facilitate productive external engagement and coordination. Serves as support to the VPSMD and the Senior Clinical and Business Leadership team by leading the development of selected tactical and operational plans to meet enterprise and department goals. This will require building relationships across the organization with emphasis on the Clinical Operations and Medical organizations, understanding key operational challenges faced by teams, and participating in the development of appropriate and timely solutions to address such challenges. The role will help align team projects and initiatives, so they are on an effective trajectory to achieve those goals. The position offers the opportunity to interact with all levels of management taking an active role in the successful execution of Healthfirst projects and initiatives.
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Duties & Responsibilities:
- Supports in translating strategy into short, medium and long-term plans.
- Works collaboratively in preparing reports, presentations and/or papers to present to internal and external leaders as required.
- Aligns work activities and coordinates schedules, projects, and programs; and makes effective suggestions and recommendations.
- Facilitates discussions/meetings to support business process planning (i.e. current state process mapping, future state process design, root cause analysis, etc.)
- Analyze process workflow, identify and implement changes to gain efficiencies, forecast requirements; analyze variances; initiating corrective actions. Monitor and track trends.
- Supports and champions initiatives as directed.
- Acts as the interface with other functions.
- Develops and maintains an inventory of business processes within department standards, in accordance with business decisions, technology changes and annual audits.
- Drafts the agenda for Meetings and arranges for in-person meetings, following up on the same with minutes/action Items.
- Develops documentation with little supervision and rework.
- Operates as a champion of change and steward of the team members through the ever-changing landscape of processes and systems
- The Senior Operations Manager will work to meet and exceed business objectives ensuring consistent achievement of all financial and operational KPIs.
- Oversees the execution and delivery of departmental productivity metrics; and customer-service standards;
- Communicates customer issues and devise ways of improving the customer experience, including resolving problems and complaints
- Enforces compliance with written and electronic documentation and data entry including HIPAA standards for confidentiality.
- Additional duties as assigned.
Minimum Qualifications:
- Bachelor's degree from an accredited institution and/ or 5-7 years of Operations Management Experience
- Project management experience with or without certification.
- At least 3+ years' experience in healthcare processes and needs.
- Experienced in applying principles and practices of program development and project administration.
- Ability to drive, track and report execution progress
on programs, and projects. - Strong relationship building skills, able to influence internal and external stakeholders, and high EQ.
- Experience interpreting and administering policies and procedures sufficient to administer, discuss, resolve, and explain them to staff and other constituencies.
- Experienced working effectively to meet deadlines and can adjust to changing priorities.
- Strong communication skills, professional presence, and ability to engage effectively with stakeholders at all levels.
- Collaborative and able to motivate and energize cross functional team members to achieve aggressive goals.
- Strong problem-solving, and analytical skills, able to facilitate discussions among groups with diverse technical expertise, and progress decisions on complex issues.
- Substantive experience in Word, Excel and PowerPoint.
- Experience with SharePoint or other similar document sharing platforms.
Preferred Qualifications:
- Experience working in the insurance industry, preferably in health care, business or related environment.
- Translating and interpreting data and analytics to set key business strategy
- Previous experience managing an administrative support department
- Working knowledge and understanding of medical terminology
- Superior communication skills, both written and oral. Ability to multi-task.
- Experience in supporting business process optimization with experience in two or more areas of Healthcare/Health Plan customer service, enrollment, billing and/or claims processing.
- Experience with Six Sigma project management philosophies a plus.
Compliance & Regulatory Responsibilities: Noted above
License/Certification: N/A
Hiring Range:
- Greater New York City Area (NY, NJ, CT residents): $119,900 - $183,430
- All Other Locations (within approved locations): $102,600 - $156,655
As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.
In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.
The hiring range is defined as the lowest and highest salaries that Healthfirst in "good faith" would pay to a new hire, or for a job promotion, or transfer into this role.
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.