This position manages a team of supervisors (and possibly associates) within assigned unit in Operations. Manages payer, provider and patient complaint resolution. Monitors overall performance and productivity of the unit and ensures supervisors take appropriate action to ensure department goals and metrics are met including, but not limited to regular scheduled and just-in-time coaching, recommending re-training, performance management and mentoring associates. Consistently identifies areas of opportunity/process improvement within department and recommends and implements solutions as necessary.
• Works with department supervisors to ensure metrics are met. (TAT & PG’s)
• Supports management in driving strategic direction at the supervisor and staff level.
• Support supervisors on escalated calls, 3rd point of contact.
• Manages payer, provider and patient complaint resolution.
• Works with supervisors and staff employees to drive efficient call volume activity and management.
• Work with supervisors to create efficient work plans and daily assignments.
• Supports cross-functional process improvement efforts.
• Keeps abreast of technological and industry developments
• Processing of all direct reports timecards and ensuring all associates are completed.
• Creation and sign off of all Oscar requests.
• Reward and recognize associates monthly for performance above and beyond expectations.
• Create audits for external customers and report on findings.
• Perform interviews for new hires and tracking for all requisitions.
• Reviews and adheres to all Company policies and procedures and the Employee Handbook.
• Other duties as assigned.
• Responsible for signing off on all sales adjustments.
• Develop and administer operational policy.
• Participates in bimonthly calibration calls for Ulysses.
• Daily reporting on patient related cases.
• Daily patient cases updates.
• Corporate, Human Resource, and or provider related communications to supervisor.
• Performance management of staff
• Corrective action plans written when applicable.
• Process and client production improvement plans
• Support on individual budgets.
Bachelor’s Degree or the equivalent plus a minimum of two years of experience in supervising/managing others required. A minimum of 3 years of experience in operations, preferably in the medical, insurance or healthcare field is also required. Thorough knowledge of healthcare delivery/managed care regulations, contract terms/stipulations, capitation requirements and accepted home health standards of practice required. Knowledge of Excel, Word and Outlook is also required.
CareCentrix maintains a drug-free workplace in accordance with Florida’s Drug Free Workplace Law.