Director Medicaid Eligibility

Salary depends on experience
Posted on 06/29/18
8 - 10 years experience
Healthcare
Salary depends on experience
Posted on 06/29/18

Job Description

Job Purpose:  Leads Medicaid Eligibility operations within assigned regional area and may require relocation and travel within region, ensuring external client satisfaction.  Provides management oversight of processes and results as expected by senior leadership. Ensures achievement of revenue and expense (P&L) goals. 

Essential job functions:
1.      Drive operational performance. Ensure processes, people and analytics are in place to drive production and profitability. Develop and enforce sustainable, repeatable processes.

2.      Assure quality results and adherence to policies, procedures and work standards.
3.      Manage employees across multiple client sites. Establishes adequate staffing levels to effectively manage operations.  Adjusts levels as necessary for new business or expanded services.
4.      Oversee management activity relating to hiring, training, coaching, monitoring, appraising, disciplining and terminating within assigned area to ensure a quality workforce. 5.      Coach and develop subordinate leaders and, through the leadership team, ensure that staff are effectively coached and developed for driving high performance and effectively and efficiently handling current and anticipated targets/goals. 
6.      Work closely with the Division President/Sr. VP to determine production goals based on client placements, expectations, type and other relevant parameters.  Proposes adjustments to budget plans as necessary.
7.      Participate in activities associated with the integration of acquired companies.
8.      Effectively manage P & L activities within assigned area.
9.      Participate or lead in developing/establishing standard methodologies and processes to effectively deliver results
10.  Participate with Regional Directors in planning and implementing new and current customer initiatives.
11.  Ensure effective communication with clients. Ensure all required reporting is completed timely and accurately. Act as central point of contact for operational issues impacting key clients within assigned area.
12.  Ensure client contracts within assigned area are properly administered.
13.  Provide direction in analyzing and resolving escalated customer and/or technical issues/problems in a timely and effective manner. May act as an individual contributor or knowledge expert for the more complex or difficult issues/problems. Exercise judgment and act appropriately within defined regulations, client requirements, policies and procedures for properly handling issues/problems.
14.  Establish and manage to Key Performance Indicators (KPI’s), by client and report results. Identify performance trends and risks. Facilitate activities to address and resolve.
15.  Working with clients and sales, identify opportunities to cross sell service line. Serve as a subject matter expert on operational issues. Participate with new contract implementations working with the Regional director to coordinate the daily operation flow to ensure optimum staff performance.
16.  Assess staff, work flows and systems regularly.  Implement/propose streamlined and/or change existing processes to improve overall client performance while maintaining profitability or creating more cost effective uses of resources. 
17.  Provides updates on procedural and client oriented changes and updates department manuals or other written materials. 
18.  Provides effective and timely communication above and below. 
19.  Perform special projects or other activities as assigned.

Job Requirements

Ø  Knowledge: Proven expertise and demonstration of general management practices.   Strong business acumen and understanding of operational metrics, financials, and performance indicators.  Bachelor’s degree in Business Administration, Healthcare Administration or related field. Master’s preferred. Working knowledge of the healthcare receivables management industry preferred.
Ø  Experience:  A minimum of 7-10 years experience, with at least five in a senior leadership role.  Strong familiarity of operational concepts, analytics, practices and procedures.  Previous experience working in a high performance, high growth organization.  Prior experience developing and implementing repeatable processes that can be perfected over time.  Ability to assess and develop staff. Effectively uses tools to access and use information for managing business
Ø  Competencies:  Demonstrated leadership, analytical, communication and problem solving skills and the ability to act/decide accordingly. Ability to collect, synthesize and research complex or diverse information. Ability to coach and develop leaders who, in turn, have the ability to develop other staff. Exceptional customer service and the ability to plan, organize and exercise sound judgment.   
Disclaimer:  The above statements are intended to describe the general nature and level of work being performed.  They are not intended to be an exhaustive list of responsibilities, duties and skills required.

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