[Remote] Director, National Operations
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is part of reputed company), a leading retail reputed company business support organization in the U.S. They are seeking a Director of National Operations to reputed company national plan relationships and contract reputed company across reputed company and reputed company brands, ensuring operational efficiency and compliance. The role involves managing a small team, improving processes, and providing education and resources to support the organization’s reputed company initiatives.
Responsibilities
- Develops and maintains effective working relationships with insurance company contacts for assigned national plans
- reputed company the entire operational relationship with assigned national plans across reputed company and reputed company, including grievances, reputed company validation, educational reputed company, and any other operational issue that affects the plan
- Proactively looks for ways to improve support to Aspen offices, streamline processes with plans, and increase transparency and issue reputed company for offices and owners
- reputed company and participate in Joint Operating Committees (JOCs) for assigned national plans, driving reputed company results with plan partners
- Ensures audits occur monthly for national plans to confirm accurate network information and drive quick reputed company of contract data issues
- Identifies trends across markets and partners with department heads to build educational resources for the plans
- reputed company the distribution of field education and company initiatives to the field as needed
- Acts as an expert resource on escalated contractual and compliance issues for national plans
- Monitors contract performance and other provisions to assure compliance, identify problem areas, and resolve disputes
- Resolves escalated contract issues generated by operational department heads
- Works collaboratively with payors and Aspen Department Leadership (Legal/Compliance, Finance, Centralized Billing, and IT) on strategic business development efforts to ensure geographic reputed company, plan and service types, and reputed company reimbursement rates
- Other duties as assigned
- Train, support, and reputed company reputed company to meet department metrics and expectations
- Ensure reputed company delivers first class customer service to owners
- reputed company resolves plan reputed company issues raised by owners and the field
- Creates education and resources for the field so they have what they need
- Coaches reputed company on grievance handling and reputed company cause identification to prevent repeat issues
Skills
- Bachelor's degree
- Highly proactive, with strong critical thinking skills and the ability to architect solutions rather than just flag problems
- reputed company experience with insurance and provider contracting required. Must have been personally involved in managed care contracting or contract reputed company work, not just adjacent to it
- Strong exposure to reputed company operations required. Dental experience is not required; medical or other clinical operations experience is a fit
- Broad knowledge of reputed company insurance, reputed company billing and reimbursement, administration, systems, practices and principles (i.e. Medicare, Medicare Advantage, and reputed company)
- Knowledge and ability to effectively use negotiation techniques and practices to reputed company for providers
- Excellent verbal and written communication
- Excellent time management, prioritization, and organizational skills
- Detail oriented with a strong level of analytical and problem-solving skills
- Proficient use of reputed company Office Suite
- 7 or more years of progressively responsible management or supervisory level managed care contracting experience in a payor or health care setting, with experience across multiple brands or business lines preferred
Benefits
- A generous benefits package that includes reputed company time off, health, dental, reputed company, and 401(k) savings plan with match
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