Area Director

Company: CareMetx
Location: Saint Louis
Posted on: September 16, 2020

Job Description:

Under the general guidance of the Vice President, Strategic Initiatives the Area Director will serve as a field or home-office based regional leader for one of the Company’s Micro-Hubs. In this capacity, the Area Director will oversee all staff and be responsible for the end to end work product and customer service for their region. They will work with the Vice President of Digital Hub to ensure all aspects of the Micro-Hub comply with the company’s standard operating procedures. They will also collaborate with the Vice President of Strategic Initiatives to constantly refine best practices for achieving the company’s production, customer service and revenue goals. Staff will include a combination of both salaried and temporary employees. The Area Director will be responsible for working with the Vice President, Strategic Initiatives, and members of the recruiting team to hire and train the necessary volume of temporary employees to accommodate assigned CareMetx-Seasonal initiatives associated with benefit re-verification projects. Throughout the duration of these initiatives, the Area Director will work with their team of supervisors to ensure all temporary employees meet company standards and achieve specific service-level agreements for daily and weekly productivity. This position is also required to participate in various customer management and market development activities, including, but not limited to, weekly management calls during re-verification periods and ongoing relationship development efforts with local payers. PRIMARY DUTIES AND RESPONSIBILITIES: Oversee the administration of a CareMetx Micro-Hub. Act as the management liaison for the Micro-Hub to the rest of the CareMetx organization. Lead a team of Supervisors responsible for coaching a group of remote Reimbursement Specialists. Ensure excellence in all aspects of customer service. Work with the VP of Strategic Initiatives to ensure goal attainment during benefit re-verification periods. Provide leadership for recruiting efforts designed to achieve staffing levels during benefit re-verification planning periods. Collaborate with the VP of Digital Hub to ensure successful project management activities during benefit re-verification periods. Develop productive relationships with assigned local payer organizations. Provide reporting and data to support daily and weekly business intelligence around key performance indicators. Assist Supervisors with handling escalated challenges associated with benefit investigations Assist with resolving general reimbursement challenges. Provides information on relevant reimbursement topics related to our client’s products. Effectively collaborates and communicates with other members of the management team involved in Hub operations. Provides exceptional customer service to internal and external customers resolves any customer request in a timely and accurate manner, escalates complaints accordingly. Assist in development of standard operating procedures regarding Hub operations, benefit investigations, hiring and training. Monitors performance against benchmarks and works with supervisors to suggest changes and solutions as appropriate. Independently and effectively resolves complex challenges with minimal supervision. Handles management issues where analysis of situations or data requires an in-depth evaluation of variable factors. Networks with key contacts outside their own area of expertise. Acts independently to determine methods and procedures on new or special assignments. Exercises judgment in selecting methods, techniques, and evaluation criteria for obtaining results. Performs related duties as assigned. Qualifications EXPERIENCE AND EDUCATIONAL REQUIREMENTS: 5+ years’ experience working in a supervisory or management position within medical insurance or with specialty healthcare providers reimbursement, patient assistance programs, financial assistance programs, and other pharmaceutical reimbursement related activities. Experience managing a diverse staff (remote management experience is highly desirable) Technical knowledge of healthcare reimbursement including benefits investigations, coding, billing, appeals process, and navigating complex reimbursement issues with payers and as needed with members of the client team. Bachelor’s degree or specific Practice Management experience preferred MINIMUM SKILLS, KNOWLEDGE AND ABILITY REQUIREMENTS: Strong leadership and supervisory abilities. Ability to communicate effectively both orally and in writing. Ability to lead training and coaching sessions with employees. Ability to build productive internal/external working relationships. Strong interpersonal skills and attention to detail. Ability to manage multiple tasks under deadline. Strong analytical skills. Excellent presentation skills. Knowledge of call center operations and insurance support centers is highly desirable. Advanced knowledge of medical insurance terminology Strong teamwork abilities Project management skills Ability to work remotely and manage/coach a diverse remote workforce Strong organizational skills; attention to detail. Ability to resolve associate issues effectively and efficiently. Ability to proficiently use Microsoft Excel, Word and PowerPoint. Proven ability to appropriately escalate issues to management. Knowledge of private payer, Medicare and Medicaid structure systems and reimbursement processes. Understanding of patient privacy laws including HIPAA and similar state laws Ability to travel for team meetings within defined geography. Ability to travel overnight Ability to schedule individual work-related travel (air, hotel, rental car as needed). Ability to utilize own car for travel. Technical knowledge of healthcare from a patient and provider perspective (miscellaneous codes, billing codes, appeals process). Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit. The employee must occasionally lift and/or move up to 10 pounds. Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.

Keywords: CareMetx, St. Louis , Area Director, Other , Saint Louis, Missouri