Operations Director - Provider Solutions
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.
As the Director of Operations 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 Director 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.
- Gain a thorough understanding of customer requirements through direct interaction with client and via Client Executive and project management teams. Continuously strive to identify operational efficiency and execution opportunities and improve the customer experience.
- Develop and implement the Elevate! Risk Assessments program’s operational strategy, to ensure it meets the business requirements and customer deliverables, as well as ensuring the departmental performance against goals.
- Participate in overall Elevate! Risk Assessments program strategy and help drive operational goals that meet overall product goals.
- Implement and monitor all operational departmental systems to ensure Advantmed Standards are met.
- Provide strong, dynamic leadership that mentors, develops, and guides team members to efficiently leverage the value of every call for maximum client delivery
- Manage all validation activities, including validation strategy and approval of protocols and reports.
- Deliver results against a defined scope of work that includes measurable Financial ROI, strategic innovation, performance reporting, and human capital development
- Develop and maintain effective organization of responsibility, including efficient recruiting, training, coaching, recognition, workflow patterns, performance standards, delineation of duties and responsibilities, staffing levels and supervision
- Coordinate analytic, strategic and technical resources to meet client expectations and insure satisfaction
- Ensure compliance with regulatory agency guidelines and standards.
- Ensuring that the department meets or improves on budget, cost, volume and efficiency targets (KPIs) in line with business objectives.
- Follow Advantmed Value system to ensure excellent relations and communications with all members of the team. Respond politely and in a timely fashion to internal and external customers
- Undertake any other duties, either for this department or any other department within the business, which may be requested by the COO.
- Minimum 2 years of experience & exposure at director level of creating/ heading / leading a department in mid to large organization.
- Extensive experience providing practical direction on information and Management platforms.
- Current or past experience overseeing an in home health risk assessment program for a national or regional organization
- Past experience working with offshore teams
- Ability to travel up to 30% of the time
- Strong negotiating and consensus building abilities.
- Experience in Project Management and Six Sigma
Previous experience should include:
- • Experience in provider relations, specifically hiring, managing and developing compensation models for medical professionals.
- • Experience in patient engagement including strategies to improve engagement
- • Passion for delivering the highest quality to services to patients
- • Experience running a call center or remote scheduling teams
- • Ability to create and manage teams including motivating virtual and matrixed teams
- • Experience of managing Remote employees and multiple locations
- • Ability to be the lead client facing operations lead, understand project requirements, identify challenges early on and manage projects to client objectives
- • Excellent understanding of technology and ability to contribute to requirement designed to improve operations and the customer experience
- • Ability to work in operational environment at a senior level
- • Experience managing metrics, ensuring customer satisfaction, and reporting statistical performance levels related to Call Center and Provider Network
- • Excellent attention to detail, with the ability to work accurately in a busy and demanding environment
- • Ability to express complex operational concepts effectively, both verbally and in writing
- • Ability to effectively prioritize and execute tasks in a high‐pressure environment
- • Excellent problem-solving skills
Compensation: Commensurate with experience. In addition, Advantmed offers health, dental, vision, and 401k retirement incentives competitive with industry standards.