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Operations Manager

Operations Manager - Provider Solutions

 

 

About Advantmed:


Founded in 2005 and based in Santa Ana, California, Advantmed, LLC (dba RecordFlow until 2015) is a healthcare information management company that helps health plans, managed care organizations, and life insurance companies optimize revenue and improve quality outcomes.

Advantmed partners with managed care organizations to deliver the optimal combination of capabilities unique to each organization needed to achieve the objectives, including risk analytics, NCQA-certified HEDIS ® Measures software, medical record retrieval, medical record abstraction, risk adjustment coding, and provider education.

 

Job Summary:

As the Operations Manager, you will assist the Chief Operating Officer with a long range planning for the fiscal viability of assigned locations. In addition, you will plan and develop community outreach strategies as well as establish mechanisms for measuring quality care and organizational performance. The Operations Manager coordinates and oversees all direct patient care services provided by clinical personnel in the patients' home environment. The Director of Operations is responsible for ensuring that patient care is coordinated and managed appropriately in a cost effective and financially responsible manner. The Operations Manager is responsible for ensuring that care and services are delivered appropriately as well as the supervision and training of clinical personnel.

 

Core Expectations:

  • Chronic Care Management (CCM): The CCM service is extensive, including structured recording of patient health information, maintaining a comprehensive electronic care plan, managing transitions of care and other care management services, and coordinating and sharing patient health information timely within and outside the practice. CCM services are typically provided outside of face-to-face patient visits, and focus on characteristics of advanced primary care such as a continuous relationship with a designated member of the care team; patient support for chronic diseases to achieve health goals; 24/7 patient access to care and health information; receipt of preventive care; patient and caregiver engagement; and timely sharing and use of health information.

Work with account manager to setup a new provider

                                    i.      List of eligible members
                                   ii.      Login to EMR
                                 iii.      Letters to the eligible members

  1. Weekly and monthly reporting to provider
  2. Work with member engagement team lead and care coordinators team lead for a smooth operation
  3. Co-ordinate monthly billing and collection with account manager and accounting department
  4. Make sure all the information is updated on intranet for reporting purposes
  5. Responsible to provide or coordinate care coordinator training and answer their questions
  6. Co-ordinate to resolve any issue related to day to day operation

 

  • Home Assessment Program: The in-home assessment is a voluntary program offered to beneficiaries in their homes. Assessments are typically performed annually by either a physician or a nurse practitioner. Purpose of the program is to assess beneficiaries’ condition and close all the preventive care gap. 
  1. Coordinate with client to inform member about the program
  2. Coordinate training of all the MAs and Providers
  3. Scheduling of providers and MAs
  4. Address all the issues or concerns providers may have
  5. Assure quality of the visit
  6. Making sure of all the deliverables to customer and primary care providers.
  7. Resolve day to day operation issues/challenge

 

Qualifications:

  • Strong communication, project and time management skills
  • Ability to establish and maintain effective working relationships across Advantmed & contracting partner providers
  • Past management experience or training experience
  • Educational Qualifications: Must have RN or Nurse Practitioner License
  • Home Health experience is preferred
  • Bilingual is a plus

 

Compensation: Commensurate with experience. In addition, Advantmed offers health, dental, vision, and 401k retirement incentives competitive with industry standards.

 

 

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