Manager - Health Plan Operations

We are seeking an experienced and dynamic Manager to oversee our Health Plan Operations. The Manager will be responsible for leading and managing the day-to-day operations of our health plan, ensuring smooth and efficient functioning of all aspects related to health plan administration. The ideal candidate will possess strong leadership skills, extensive knowledge of healthcare operations, and a proven track record of managing a team to achieve operational excellence.

Key Responsibilities:

- Oversee the day-to-day operations of the health plan, including claims processing, member services, provider relations, and utilization management.

- Develop and implement operational policies and procedures to ensure compliance with regulatory requirements and industry standards.

- Lead and mentor a team of operational staff, providing guidance, support, and training as needed.

- Analyze operational performance metrics and implement strategies to improve efficiency, accuracy, and quality of services.

- Collaborate with other departments, such as finance, IT, and compliance, to ensure seamless integration of operational processes.

- Serve as a point of contact for escalated operational issues and work towards timely resolution.

Qualifications:

- Bachelor's degree in healthcare administration, business, or related field; master's degree preferred.

- In-depth knowledge of healthcare industry regulations, compliance requirements, and best practices.

- Strong leadership and interpersonal skills, with the ability to motivate and manage a diverse team.

- Excellent analytical and problem-solving abilities, with a focus on continuous improvement.

- Effective communication skills, both written and verbal, with the ability to interact with internal and external stakeholders.

If you are a results-driven leader with a passion for healthcare operations and a desire to make a meaningful impact, we encourage you to apply for this exciting opportunity.