Location: Saint Louis
Posted on: September 16, 2020
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
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