The Vice President of Operations will provide leadership and support of the operational functions of the Health First Health Plans. This will include teams in the following areas:
Billing & Enrollment
Provider Network Operations
Develop a culture of customer focus to contribute to growth and retention of members.
Identify and develop talent for associate growth and succession planning.
Lead the development of operations needed to support new products, markets and delivery mechanisms.
Proactively identify opportunities for more reliable and more cost-effective business processes across departments, and lead change as indicated.
As Executive Champion, the VP will lead teams to successful completion of projects to enhance Operations and customer experience
Lead/oversee the development of sophisticated claims payment operations to include advanced clinical editing, fraud/abuse detection, out-of-network claims re-pricing and other activities to minimize overpayments.
Master's Degree in appropriate field.
Minimum of 10 years' experience in business operations, preferably in insurance.
Strong management skills and prior experience at a Director or VP level.
Excellent verbal and written communication skills with a demonstrated ability to communicate and work effectively with non-technical administrators.
Must be able to demonstrate strategic planning and organizational abilities.
Past success in leading enterprise wide projects to successful completion
Excellent decision making skills including the ability to sift through data and input from others and communicate decisions to achieve associate support and commitment.
Ability to focus teams for effective problem solving and goal achievement.
Advanced knowledge of healthcare financing and healthcare delivery concepts.