Director of Operations
The Director, ClinAssist is responsible for managing the ClinAssist product operations and meeting performance objectives and metrics.
Operations Management
- Maintain an annual operations development plan
- Develop (in coordination with others), implement and manage all operational systems and tools
- Manage the work in process receivables inventory
- Create and maintain all operations policies and procedures, workflows, and reports
- Monitor workflow to ensure on-time and accurate completion of Pre-Screens and Forensic Reviews and timely closure of cases under appeal or negotiation
- Complete a weekly revenue/closure forecast of cases under negotiation
- Assist in the development of audit exception arguments, research state regulations, and undertake special projects as assigned
- Assist in the development of operations key indicators and quality assurance measures and monitor and report performance at established intervals
- Analyze key indicators and quality assurance data to identify opportunities to improve workflow and overall operations performance
- Establish a strong customer service focus across the department
- Implement product cross-selling within all operations workflows; assure staff is trained and cross-selling on every case
- Ensure compliance with HIPAA and any federal and state regulations governing medical bill review
Inter-Department Coordination
- Collaborate with Product Development to implement new products and product enhancements
- Collaborate with Sales and Marketing to meet customer needs and promptly resolve customer service issues
- Collaborate with IT to develop, test, implement, and modify operations systems and reports
- Collaborate with Finance and Accounting to assist with forecasting and monitor ClinAssist budget and invoicing
- Establish and maintain appropriate staffing levels to meet customer needs and performance/quality targets
Staff Management
- Establish and maintain appropriate staffing levels to meet customer needs and performance/quality targets
- Create, implement and manage staff and consultant training program
- Assist with recruitment, credentialing and training of qualified operations personnel and consultants
- Manage direct reports and consultants
- Provide regular performance feedback verbally and in writing
- Regularly communicate to the ClinAssist team the company's vision, mission, key initiatives, and performance
Qualifications
Education and Certifications
- Bachelor's Degree emphasis in accounting or finance preferred
- Master's Degree in Business or Healthcare administration helpful
- Juris Doctor (JD) Degree or CPA helpful
Experience
- 5+ years of operations management experience with proven management and leadership skills
- 5+ years of experience in medical claims billing, reimbursement, contracting, or patient financial services, preferably in a large hospital setting, or medical claims processing for a health plan, third party administrator, or medical bill review company.
- 3+ years of experience with ERISA, state Medicaid, and healthcare insurance law highly desirable
- Experience in charge master development highly desirable
- Experience in provider contracting/negotiations or other contract negotiations highly desirable
- Experience in developing relationships and working with consultants and clinical personnel, including physicians and nurses helpful
- Experience in start-up environments or scaling company operations to meet aggressive customer acquisition targets
- Experience in managing staff, products, and projects
Skills
- Strong analytical, planning, problem-solving, and decision-making skills
- High degree of motivation, self-directness, creativity, and entrepreneurial spirit
- Ability to communicate effectively verbally and in writing with clients, senior management, direct reports, and other members of the company
- Ability to motivate employees and establish a positive team environment
- Good computer skills, including Word and Excel
