Address
Form of work Responsibilities
Job Summary: The Manager of Operations oversees the teams in resolution, training, and the front office to ensure quality service is being delivered and documented appropriately for health plan members, employer groups, brokers, insurance carriers, providers and their office staff for all lines of business. This role is primarily the managerial point of contact for the Resolution department. Will lead and act as the technical resource for complex escalatory matters, organizational processes, procedures and best practices. Assists supervisors with resolving first level and higher escalated issues and serves as the ultimate escalation point, in consultation with the Director of Operations for service-related issues prior to senior level escalation. Position is recognized as a credible leader, coach, mentor and relied upon to make sound business judgments that demonstrate complex managerial and supervisory competence.
Qualifications
Qualifications and Requirements:
EEO Statement
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
We believe that diversity and inclusion among our teammates is critical to our success.
Notice
At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449.
Job Summary: The Manager of Operations oversees the teams in resolution, training, and the front office to ensure quality service is being delivered and documented appropriately for health plan members, employer groups, brokers, insurance carriers, providers and their office staff for all lines of business. This role is primarily the managerial point of contact for the Resolution department. Will lead and act as the technical resource for complex escalatory matters, organizational processes, procedures and best practices. Assists supervisors with resolving first level and higher escalated issues and serves as the ultimate escalation point, in consultation with the Director of Operations for service-related issues prior to senior level escalation. Position is recognized as a credible leader, coach, mentor and relied upon to make sound business judgments that demonstrate complex managerial and supervisory competence.
Qualifications
Qualifications and Requirements:
- 5+ years of healthcare management experience including hiring, firing, employee coaching and training.
- 5+ years' experience working with health plans insurance products or employer healthcare benefits programs.
- 5+ years of experience in customer service with proven ability to de-escalate situations and provide resolution to customer issues.
- BS business administration, health administration, management, or equivalent experience.
- Knowledge of State and Federal regulations as they pertain to the health insurance industry.
- Experience with STAR ratings, care cap reports and risk scores
- Knowledge of CMS, NCQA, and HEDIS regulations as they pertain to the health insurance industry
- Proven experience reviewing and analyzing statistical data to identify trends as well as potential problems/opportunities for improved service quality.
- Versed in processes improvement techniques to reduce waste, and achieve efficiencies through simplifying complex processes within the Resolution department
- Ability to develop, use, interpret and apply key business metrics required
- Ability to organize and lead key initiatives required
- Knowledgeable of developing and implementing training for adult learners
- Strong written and verbal communication with an ability to effectively communicate with all types/levels of audiences required
- Experienced presentation skills and versed in public speaking
- Detail oriented; analytical ability; strong problem-solving skills required
- Advanced proficiency with all Microsoft Office Suite (Excel, Word, Visio, Outlook), and budgetary, time and attendance (Kronos) software systems.
- Resourceful and innovative in overcoming challenges through adapting, and responding quickly to change to gain efficiencies and increase productivity
- Must be able to make independent decisions, multi-task, prioritize tasks, and work with other internal departments to meet company goals.
EEO Statement
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
We believe that diversity and inclusion among our teammates is critical to our success.
Notice
At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449.
