Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes.
What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be Collaborative.
If you share our passion for changing healthcare so all people can live healthy, brighter lives – apply to join our team.
Director, Operations is responsible for people, process and technology in the NeueHealth operations. In this role you will be responsible for organizing and advancing NeueHealth operations infrastructure as it relates to system functionality, configuration and the oversite and accountability of both onshore and offshore teams. You will be accountable for driving the company’s performance and strategy by ensuring timely, efficient, and accurate performance monitoring and oversight of the operations.
ROLE RESPONSIBILITIES The Director, Operations job description is intended to point out major responsibilities within the role, but it is not limited to these items.
Ensures adherence to NeueHealth overall strategy through design and implementation of operational processes and workflows. Focus on medical claims processing.
Maintains compliance to all regulatory, state and federal laws, and plan guidelines throughout the operations, including claims processing and payment for multiple lines of business. Includes maintenance of policies & procedures and job aids.
Handles transparent daily performance monitoring for all operational functions through dashboard oversight, inventory management and provider or member issues resolution. Includes root cause analysis for repeated issues. Focus on Call Center, Claims Processing, system configuration and Eligibility.
Manage the operations team, both onshore and offshore FTE’s. Maintain clear roles and responsibilities, accountability, and structure. Includes productivity and accuracy monitoring and efficiency improvement.
Manage the configuration and customization of technology to meet business requirements. Proactively monitoring growth in the organization and set up mechanisms to allow scale in the operations.
Represents NeueHealth as the subject matter expert in all external facing joint operations meetings with clients, health plans or providers.
Provide trend analysis to internal or external stakeholders, as necessary, to escalate issues to appropriate organizational decision makers.
Responsible for internal and regulatory reporting, on a scheduled or ad-hoc basis, to stakeholders as requested.
Other duties and responsibilities as assigned.
This position has supervisory responsibilities for members of the operations team.
You should have 7+ years of operations management or claims operations experience, preferably in a managed care setting.
Previous management experience.
Results oriented with the ability to prioritize and manage multiple projects simultaneously and lead a team to consistently meet deadlines, compliance and client expectations.
Ability to work independently as well as collaborate in groups
Strong skills in listening, verbal, and written communications
Ability to think innovatively and creatively solve problems, strong analytical skills
Excellent customer service skills with internal and external stakeholders
Experience with the EZ-Cap platform is a plus.
WORK ENVIRONMENT The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer. Travel may be required.
We’re Making Healthcare Right. Together.
We are realizing a completely different healthcare experience where payors, providers, doctors, and patients can all feel connected, aligned and unified on the same team. By eradicating the frictions of competing needs, we are making it possible to give everyone more of what they want and deserve. We do this by:
Focusing on Consumers We understand patient pain points, eliminating complexity while increasing transparency, for greater access and easier navigation.
Building on Alignment We integrate and align individual incentives at all levels, from financing to optimization to delivery of care.
Powered by Technology
We employ our purpose built, integrated data platform to connect clinical, financial, and social data, to deliver exceptional outcomes.
As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.