Senior Vice President, Regional Operations - TPA Healthcare Insurance
8 - 10 years experience •
We have been retained to recruit a proven and experienced Senior Vice President - Regional Operations for an innovative provider of custom healthcare solutions. Our client is an independent Third Party Administrator of health plans for self-funded employers. This is a multi-location leadership role with progressive responsibilities.
? Serves on the senior leadership team and has shared accountability for an integrated approach to meeting overall division goals.
? Manages, coaches and develops the leadership staff.
? Accountable for achievement of mission critical and performance targets through engagement and collaboration.
? Develops division strategy, based on enterprise vision.
? Building and managing effective operational teams and processes in a distributed environment.
? Consolidating operations and improving automation to achieve maximum efficiency and effectiveness.
? Building and managing operational plans.
? Managing large-scale operations effectively using consistent processes, measurements, and scorecards.
? Developing and achieving operational standards in a multi-location healthcare payer environment working with other leaders in a Federated Model.
? Experience with self-insured service models and Medicare/Medicaid models.
? Obtaining, analyzing, preparing and presenting complex information effectively using both detail drill-down and exception-based reporting methods.
? Providing Operational expertise and support to all areas of the Company.
? Creating value through reducing expense and generating revenue.
? Collaborating with peers, managers, and C-level executives.
? Exceptional oral, written, presentation and interpersonal communications skills; ability to effectively interact with internal and external customer and team members
? Demonstrated ability to achieve results through team efforts, willingness to challenge established practices and draw relevant conclusions; ability to persuade, market and sell new ideas and the ability to work effectively in a diverse work group
? Ability to identify, analyze and resolve business issues through solution-oriented projects
? Ability to adapt to rapidly changing technology and apply to business needs
? Ability to perform in a high pressure environment and/or crisis situation and render good decisions to resolve the problems.
? Must demonstrate good judgment in managing resources.
? Analytical independent problem-solver with a can-do attitude.
? Demonstrated client service acumen and communication skills. Excellent oral and written communication skills.
? Act as business advisor to Operations teams on new business models, new business processes, changing business processes, including M&A Integrations, etc.
? Provides direction to and support of Operations teams.
? Establishes location-specific business plans, budgets, and staffing models.
? Implements process and technology improvements to improve ROI and optimize workflow accuracy and efficiency.
? Maximizes client retention and prospect conversion through consistent operational execution, visible client service ethic, and support of Account Management and Sales activities.
? Actively creates accountable and fun work environment for staff and supports talent acquisition, retention, and development.
? Develops and maintain locationstaffing models
? Contribute to and maintain in-depth knowledge of the Company?s strategic business plans.
? Ensure regulatory compliance of Operations.
? Identifies operational gaps and develops and implements solutions.
? Validate and ensure Operations are aligned and follow company strategy and operational standards.
? Ensure optimal performance of the function. Recommends and implements processes, technology, and techniques to improve productivity, increase efficiency, reduce costs, and maintain industry standard practices.
? Keep abreast of current trends and practices in field of expertise
The Senior Vice President ? Regional Operations will have at least ten years?experience in the healthcare payer sector, and five years?experience in managing healthcare payer operations: achieving financial objectives; achieving quality and performance objectives; directing claims payment and call center operations; interacting with clients, prospects, brokers and partners; a commitment to staff development, morale, and accountability; achieving regulatory compliance; and contributing to strategic and tactical planning. The position requires experience with distributed organizations in a complex business environment. He/She will have excellent leadership skills with passion and commitment to help team members and clients achieve their maximum potential. A strong presence with excellent communication skills and leadership ability is required.
Specific qualifications include:
? Bachelor?s degree with ten years group insurance operations experience, including a minimum of five years management experience within the industry or its equivalent.
? Exhibit strong interpersonal skills with customers, vendors, employees and all levels of management. Excellent communication, leadership and industry experience. Requires frequent contact with senior client staff and brokers. While a separate Account Management department exists, this position nonetheless will be responsible for managing the relationships for major clients.
? Self motivated, highly organized and results oriented. Strong analytical and problem-solving skills. Ability to see the big picture and manage varying initiatives and operations to achieve the Company?s objectives.
? Medicare administration experience and technical background desired.
? Project management certification or experience a plus
? Independence, flexibility, creativity, and problem solving to produce rapid results with minimum direction in a complex environment
? Strong operational management skills with experience in proactively monitoring both workload and client commitments with the ability to create reference caliber client satisfaction levels
? Competency and flexibility in understanding diverse and complex business and technical problems, client requirements, and functional/business objectives while developing efficient and effective solutions
? Possess strong analytical/problem solving skills and communication (both oral and written) skills