Director Of Clinical Operationis - Health Services/Management position at Maxim Healthcare Services in

Maxim Healthcare Services is at present recruited Director Of Clinical Operationis - Health Services/Management on Wed, 17 Jul 2013 18:20:35 GMT. The Director of Clinical Operations will be responsible for leading the Commercial, Medicaid and Exchange teams within Clinical Ops and will be responsible for the daily operations and leadership of this organization. This includes Commercial and Medicaid prior authorizations, data entry, appeals, and exceptions. The Director will be responsible for budget adherence. This position will drive the...

Director Of Clinical Operationis - Health Services/Management

Location: , New Jersey

Description: Maxim Healthcare Services is at present recruited Director Of Clinical Operationis - Health Services/Management right now, this position will be placed in New Jersey. Further informations about this position opportunity please read the description below. The Director of Clinical Operations will be responsible for leading the Commercial, Medicaid and Exchange tea! ms within Clinical Ops and will be responsible for the daily operations and leadership of this organization. This includes Commercial and Medicaid prior authorizations, data entry, appeals, and exceptions. The Director will be responsible for budget adherence. This position will drive the the standardization, consistency and compliance in practices, procedures and workflow to improve efficiency, quality and federal/state compliance (ERISA, HCR, Exchanges, Medicaid State regs, etc.).

Job Functions/Tasks:
The Director must understand client goals, expectations and objectives that drive a positive member and client experience. The Director will have oversight of client performance guarantees and billing. The role will also partner with Finance to develop an annual business plan for the department to include revenue and expense forecasts, resource justifications and performance analysis of the department.

The Director will provide the necessary tech! nical expertise and act as a SME to support projects, address ! plan members & regulatory issues and initiatives. The Director will be instrumental in driving the facilitation of operational process and product/program improvement that will overall drive cost reduction within the organization. This position will partner with Ops Technology to ensure system compliance with all federal and state regulations, accreditation organizations and client requests.

Other key areas of focus include quality improvement, innovation and reduction of unit costs. Responsibilities of the position include daily oversight, staff development, budget management, regulatory compliance and audit readiness. The leader will work with internal partners and the operational staff to ensure ability to deliver efficient compliant processes that result in a positive physician, member and client experience.

Responsibilities include:

• Handle daily operational plans, review key metrics and conduct regular operational meetings. Cultiva! te a strong internal culture designed around collaboration, feedback, motivation, and accountability. Directs the operation and growth of the department. Collaborate with internal business partners to maintain all contractual performance guarantees. Drive programs/project implementation on time, within budget while securing necessary resources.
• Manage the department budget development and adherence. Drive cost reduction and revenue generation activities within the department.
• Understand and ensure system and process end to end regulatory compliance with all state, federal and other regulatory or client requirements. Work with Compliance, Client Services/Account Management, IT, and various internal departments to coordinate operational initiatives that achieve compliance, cost reduction or client program requirements. Work with peers and staff to ensure understanding and execution of operational and business requirements.
• Understand client contract! ual agreements that impact the prior authorization and appeals organiza! tion.

Essential education:

• Bachelor's degree required

Essential requirements:

• At least 9 years of relevant work experience required that includes at least five years in a leadership position. Clinical Services Operations or Management experience
• Strong leadership skills, demonstrated by the ability in leading large teams of individuals to successful outcomes.
• Ability to cultivate a strong internal culture designed around collaboration, feedback, motivation, and accountability.
• Strong communication and interpersonal skills.
• Demonstrated ability to work in fast pace, multi-tasking team environment while meeting deadlines.
• Highly skilled in leading significant change efforts and in building strong partnerships with business-line executives.
• Ability to summarize complex issues and problems into a concise report, focused on key findings and outcomes
• Profic! iency in developing communication strategies for a wide array of audiences that support strategic objectives
• Demonstrated sophisticated written and verbal presentation abilities; substantial experience with the development of presentation materials (collateral, proposals, presentations, talking points, etc.); proficiency in the management of time, flexibility, and influencing colleagues to meet demanding project/request timelines; developed ability to use various PC software programs: Microsoft Word, Excel, Access, and PowerPoint; UM or PA system knowledge desired but not required.
• Strong verbal and written communication skills and ability to form cross functional partnerships to accomplish goals.
• Strong coaching and interpersonal skills
• Ability to cultivate a strong internal culture designed around collaboration, feedback, motivation and accountability.
• Strong leadership and collaboration skills that drive results.

Qualifications include:

• Current Registered Nurse Lice! nse for the state in which the nurse practices.
• Full command, verbal and written, of the English language.
• Current Health Certificate (if applicable).
• Current PPD or Chest X-Ray.
• One year prior professional nursing experience preferred.
• Current BLS card.

Maxim employees are our greatest asset. We offer the following benefits:

• Medical, Dental, Vision, and Life Insurance
• 401k Program
• Competitive Pay
• Flexible Scheduling
• Direct Deposit
• Positive Work Environment and Friendly Staff Bonuses
• Travel Benefits (as applicable)
• 24 hour on- call service

Since 1988, Maxim Healthcare Services has become one of the largest employers of clinicians in the nation. At Maxim Staffing Solutions, a division of Maxim Healthcare Services, we’re known for our quality of patient care, commitment to employee development and emphasis on customer service. M! axim knows that you deserve great benefits, flexible scheduling and rewarding assignments, so our Healthcare Recruiters will match your skills, experience and schedule in order to find you the best assignments in top medical facilities. Maxim Recruiters are always available to provide you with the assistance you need to get your job done, so call us today; Maxim has a solution for you.

EOE/AAE

Related Keywords:
r.n., rn, registered nurse, nursing, er, emergency, practical nurse, medical, surgical, obstetrics, pediatrics, intensive care unit, icu, i.c.u., E.R
- .
If you were eligible to this position, please give us your resume, with salary requirements and a resume to Maxim Healthcare Services.

Interested on this position, just click on the Apply button, you will be redirected to the official website

This position will be started on: Wed, 17 Jul 2013 18:20:35 GMT

Apply Director Of Clinical Operationis - Health Services/Management Here