Director, Operations
San Antonio, TX San Antonio, TX Full-time Full-time Estimated:
$74.
9K - $94.
9K a year Estimated:
$74.
9K - $94.
9K a year Description:
Title:
Director, Operations Reports to:
Senior Vice President, Operations Status:
Full Time / Exempt Date:
1/31/2022 Job
Summary:
The Director, Operations works closely with the SVP of Operations to ensure that the organization is well-positioned in a rapidly evolving and competitive environment by being an agent for ongoing organizational change.
The position is responsible for the management and oversight of the Intake, Fulfillment, and QA Nurse departments.
Additionally, this position is responsible for the processes and function of the daily administrative workflow efficiencies for ProPeer.
Oversees daily operations, which includes supervising the operational team performing all aspects of the UR business line and IRO business line.
The goal is to achieve clinical, financial, and utilization goals through effective management, communication, and role modeling.
The Director, Operations is responsible for carrying out assignments in a manner to assure success in financial management, human resources management, leadership, quality, and operational management objectives.
The Director, Operations participates in program development and unit performance improvement.
The Director, Operations consistently demonstrates the core values of ProPeer and serves as a role model to other employees.
Essential Job Functions Effectively leads, supervises, and directs the workload of the IRO Responsible for workflow and production expectations Reviews performance against operating plans and standards.
Provides reports to subordinates or interpretation of results and approves changes in the direction of plans Ensures that the Quality Assurance Nurse department completes client-specified work according to client specification Presents monthly reports on performance as requested by the SVP, Operations Develops and presents to the SVP, Operations matters requiring a decision outside of the authorization level Develops and recommends objectives in each area of Operations Clinical account management that results in top-notch client service, as well as a positive work environment, fostering a pattern of long-term staff retention Develops specific short-term and long-term plans, processes, and programs, together with supporting budget requests and financial estimates Coordinates and collaborates with other departments of the organization in establishing and carrying out responsibilities Reviews operational projects involving major functional changes within the organization's functional areas and creates change management plans for approval by the SVP, Operations Develops plans for new areas of technology for the operational functions along with sufficient planning for areas that support the mission of the organization within Operations Establishes objectives and processes governing the performance of assigned activities.
Conducts URAC audits in conjunction with Compliance Director Selects and maintains qualified personnel in all positions reporting to Operations and provides the necessary coordination between activities Identifies training needs, initiates development of subordinates, recommends effective personnel action Participates in the development and management of department budgets and productivity targets Manages human resources utilization, promotes employee satisfaction, supports staff development, and utilizes the progressive discipline process when appropriate Ensures that workflow operations complete client-specified work according to client specification Participates in quality improvement processes and assures implementation of regulatory standards Oversee and mediate interdepartmental problems/issues and takes corrective action in a timely manner and promotes respectful responsive communication between departments Establishes, evaluates, and monitors UR processes, policies, and procedures Support company and departmental QA/QI initiatives and IRR initiatives Performance monitoring of all team members Produces production and quality reports for each month Works in coordination with SVP, Operations in the development of Nurse educational programs.
Maintains appropriate communications within areas of responsibility Keeps subordinates/employees informed as to the organization's plans and progress Consults with all segments of management responsible for policy or action.
Ensures compliance within the area of responsibility.
Makes recommendations for improving the effectiveness of policies and procedures.
Submits budget for assigned activities in accordance with the budget procedure.
Provides orientation and on-the-job training for subordinates and ensures that the authority and responsibility for each position are defined and understood Ensures that duties, responsibilities and authority, and accountability of all direct subordinates are defined and understood Assumes other activities and responsibilities from time to time as directed Requirements:
Knowledge and Abilities Requirements:
Current knowledge of utilization review/IRO processes Demonstrates ability to independently identify and define potential and/or current issues of concern, collect and analyze data, establish facts, draw valid conclusions, and exercise discretion and sound judgment.
Shall have knowledge of or ability to learn financial management related to UM/IRO function and reporting, quality improvement processes, and human resources management Shall be able to effectively monitor, evaluate and administer the resources of each assigned area and make substantiated recommendations regarding resource allocation needs for future planning purposes Ability to identify trends through analysis of practices to improve the overall utilization of resources and cost containment Ability to communicate those trends found through an analytical study using a variety of reporting mediums Proven ability to recruit, train and motivate personnel to balance staffing strength with profitability and growth Ability to make recommendations for organizational change to improve the UM/IRO efforts of the organization Ability to represent UM/IRO in organizational committees as assigned Excellent relationship management skills, including a high degree of professional demeanor and non-aggressive assertiveness Demonstrated ability to problem-solve complex, multifaceted situations Ability to engage easily in abstract thought Strong organizational and task prioritization skills Strong analytical, numerical, and reasoning abilities Participative management style (advocates team concept) Well-developed interpersonal skills.
Ability to get along with diverse personalities.
Tactful, mature.
Ability to establish credibility and be decisive - but able to recognize and support the organization's preferences and priorities Results oriented with the ability to balance other business considerations Knowledgeable of URAC Comprehensive IRO Policies and State/Federal External review regulations Ability to construct grammatically correct documents using standard medical terminology when necessary Computer literacy in Microsoft Office products and database programs Ability to travel for various meetings (client and company) Education and
Experience:
Bachelor's Degree preferred Minimum 3-5 years of upper management License and Certification:
N/A Driving Essential:
No Position Demands:
This position requires sitting, bending, stooping for up to 8 hours per day in an office setting.
Ability to lift and move objects weighing up to 20 lbs.
Ability to learn technical material.
The person in this position needs to occasionally move about inside the office to access file cabinets, office machinery, etc.
Must be able to operate a computer and other office productivity machinery such as a calculator, copy machine, printer, etc.
The person in this position frequently communicates with guests, employees, and vendors and must be able to exchange accurate information.
Disclaimer The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification.
They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of our personnel.
All Nexus employees may be required to perform duties outside of their normal responsibilities from time to time, as needed.
.
Estimated Salary: $20 to $28 per hour based on qualifications.
$74.
9K - $94.
9K a year Estimated:
$74.
9K - $94.
9K a year Description:
Title:
Director, Operations Reports to:
Senior Vice President, Operations Status:
Full Time / Exempt Date:
1/31/2022 Job
Summary:
The Director, Operations works closely with the SVP of Operations to ensure that the organization is well-positioned in a rapidly evolving and competitive environment by being an agent for ongoing organizational change.
The position is responsible for the management and oversight of the Intake, Fulfillment, and QA Nurse departments.
Additionally, this position is responsible for the processes and function of the daily administrative workflow efficiencies for ProPeer.
Oversees daily operations, which includes supervising the operational team performing all aspects of the UR business line and IRO business line.
The goal is to achieve clinical, financial, and utilization goals through effective management, communication, and role modeling.
The Director, Operations is responsible for carrying out assignments in a manner to assure success in financial management, human resources management, leadership, quality, and operational management objectives.
The Director, Operations participates in program development and unit performance improvement.
The Director, Operations consistently demonstrates the core values of ProPeer and serves as a role model to other employees.
Essential Job Functions Effectively leads, supervises, and directs the workload of the IRO Responsible for workflow and production expectations Reviews performance against operating plans and standards.
Provides reports to subordinates or interpretation of results and approves changes in the direction of plans Ensures that the Quality Assurance Nurse department completes client-specified work according to client specification Presents monthly reports on performance as requested by the SVP, Operations Develops and presents to the SVP, Operations matters requiring a decision outside of the authorization level Develops and recommends objectives in each area of Operations Clinical account management that results in top-notch client service, as well as a positive work environment, fostering a pattern of long-term staff retention Develops specific short-term and long-term plans, processes, and programs, together with supporting budget requests and financial estimates Coordinates and collaborates with other departments of the organization in establishing and carrying out responsibilities Reviews operational projects involving major functional changes within the organization's functional areas and creates change management plans for approval by the SVP, Operations Develops plans for new areas of technology for the operational functions along with sufficient planning for areas that support the mission of the organization within Operations Establishes objectives and processes governing the performance of assigned activities.
Conducts URAC audits in conjunction with Compliance Director Selects and maintains qualified personnel in all positions reporting to Operations and provides the necessary coordination between activities Identifies training needs, initiates development of subordinates, recommends effective personnel action Participates in the development and management of department budgets and productivity targets Manages human resources utilization, promotes employee satisfaction, supports staff development, and utilizes the progressive discipline process when appropriate Ensures that workflow operations complete client-specified work according to client specification Participates in quality improvement processes and assures implementation of regulatory standards Oversee and mediate interdepartmental problems/issues and takes corrective action in a timely manner and promotes respectful responsive communication between departments Establishes, evaluates, and monitors UR processes, policies, and procedures Support company and departmental QA/QI initiatives and IRR initiatives Performance monitoring of all team members Produces production and quality reports for each month Works in coordination with SVP, Operations in the development of Nurse educational programs.
Maintains appropriate communications within areas of responsibility Keeps subordinates/employees informed as to the organization's plans and progress Consults with all segments of management responsible for policy or action.
Ensures compliance within the area of responsibility.
Makes recommendations for improving the effectiveness of policies and procedures.
Submits budget for assigned activities in accordance with the budget procedure.
Provides orientation and on-the-job training for subordinates and ensures that the authority and responsibility for each position are defined and understood Ensures that duties, responsibilities and authority, and accountability of all direct subordinates are defined and understood Assumes other activities and responsibilities from time to time as directed Requirements:
Knowledge and Abilities Requirements:
Current knowledge of utilization review/IRO processes Demonstrates ability to independently identify and define potential and/or current issues of concern, collect and analyze data, establish facts, draw valid conclusions, and exercise discretion and sound judgment.
Shall have knowledge of or ability to learn financial management related to UM/IRO function and reporting, quality improvement processes, and human resources management Shall be able to effectively monitor, evaluate and administer the resources of each assigned area and make substantiated recommendations regarding resource allocation needs for future planning purposes Ability to identify trends through analysis of practices to improve the overall utilization of resources and cost containment Ability to communicate those trends found through an analytical study using a variety of reporting mediums Proven ability to recruit, train and motivate personnel to balance staffing strength with profitability and growth Ability to make recommendations for organizational change to improve the UM/IRO efforts of the organization Ability to represent UM/IRO in organizational committees as assigned Excellent relationship management skills, including a high degree of professional demeanor and non-aggressive assertiveness Demonstrated ability to problem-solve complex, multifaceted situations Ability to engage easily in abstract thought Strong organizational and task prioritization skills Strong analytical, numerical, and reasoning abilities Participative management style (advocates team concept) Well-developed interpersonal skills.
Ability to get along with diverse personalities.
Tactful, mature.
Ability to establish credibility and be decisive - but able to recognize and support the organization's preferences and priorities Results oriented with the ability to balance other business considerations Knowledgeable of URAC Comprehensive IRO Policies and State/Federal External review regulations Ability to construct grammatically correct documents using standard medical terminology when necessary Computer literacy in Microsoft Office products and database programs Ability to travel for various meetings (client and company) Education and
Experience:
Bachelor's Degree preferred Minimum 3-5 years of upper management License and Certification:
N/A Driving Essential:
No Position Demands:
This position requires sitting, bending, stooping for up to 8 hours per day in an office setting.
Ability to lift and move objects weighing up to 20 lbs.
Ability to learn technical material.
The person in this position needs to occasionally move about inside the office to access file cabinets, office machinery, etc.
Must be able to operate a computer and other office productivity machinery such as a calculator, copy machine, printer, etc.
The person in this position frequently communicates with guests, employees, and vendors and must be able to exchange accurate information.
Disclaimer The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification.
They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of our personnel.
All Nexus employees may be required to perform duties outside of their normal responsibilities from time to time, as needed.
.
Estimated Salary: $20 to $28 per hour based on qualifications.
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