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VP of Operations

Company: Health Care / Hospitals / Clinics, Managed Care, M
Location: Miami
Posted on: July 13, 2018

Job Description:

Company has a bold mission to change the health of the nation by changing the way health care is delivered. Our pursuit of this mission is the driving force that brings us to work each day. We believe in embracing new ideas, challenging ourselves and failing forward. We respect and celebrate individual talents and team wins. We have fun while working hard and employees often make a difference in everything from scrubs to jeans. Are we growing Absolutely—56.7% in year-over-year revenue growth in 2016. Are we recognized Definitely. We have been named one of “Becker’s 150 Great Places to Work in Healthcare” in 2016 and 2017, and one of the “50 Great Places to Work” in 2017 by Washingtonian, and our CEO was number one on Glassdoor’s 2015 Highest-Rated CEOs for Small and Medium Companies. If you’re looking for a place where your work can be personally and professionally rewarding, don’t just join a company with a mission. Join a mission with a company behind it. Responsibilities: Define strategy and develop business case and execute on the plan for the development of core operational capabilities. Own relationships for outsourced functions related to central plan operation. Oversee the development and operations of new functions being developed by Company that are deemed to be critical to Company's core value proposition, integrated with other groups such as clinical operations, network development and technology. Lead ASO implementation efforts involving all aspects of implementation including benefit configuration, eligibility and enrollment,provider network and claims set-up, medical payment policies, member and provider service, etc. Works with benefit planning team and Employer Services to define appropriate requirements for benefit plan design. Defines requirements along with technical and operational teams for client-specific configuration/customization and assists in managing the progress of these efforts. Develops project plans and resource models to insure timely delivery of committed documents, workflows, etc. Operationalizes the implementation and ongoing management functions. Works across Government and Commercial health plan teams to insure coordinated implementations across. Documents process and workflows across the population health and health plan management functions, such as care and case management, utilization management, benefit planning, health and wellness, network development, etc. Manages ad-hoc client requests including problem-solving on administrative and operations issues Manages the quality and timeliness of client deliverables. Assists in the development of project budgets and billing reports. Participates in client calls and meetings as appropriate. Assists with the preparation and delivery of clear and concise client-friendly communications. Qualifications and Skills: 10 years+ of health plan or TPA operations management experience across a diverse set of operational areas, showing strong leadership growth. Excellent written and oral presentation skills, with the ability to engage, inspire, build credibility and engender trust across all levels of an organization. Extremely strong client management experience, having demonstrated an ability to identify, communicate and manage risks with client executives. Entrepreneurial mindset geared toward the creation, execution and continuous improvement of a new employee engagement and wellness program from the ground up. Intellectual curiosity and an ability to view old problems with a fresh perspective. Demonstrated exceptional active listening and communications skills. Bachelor’s degree required; Masters in health- or business-related discipline preferred. Excellent written, computer, and oral communication skills. Responsive to deadlines and has work completed on or before deadline 100% of the time. Ability to develop financial reporting and modeling using MS Excel and MS Access Experience leading consulting engagements: scoping, billing, strategic advice, report creation, resource determination, troubleshooting, etc.

Keywords: Health Care / Hospitals / Clinics, Managed Care, M, Miami, VP of Operations, Executive, Miami, Florida

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