The Operations Director is a highly motivated professional with 5+ years of experience successfully managing complex operations. This individual is responsible for strategic and tactical execution and management of claims, contact center and various other operations.
Job Duties Include:
Financial & Operational Management:
• Oversee financial outcomes, including claims loading, adjudication, and payments
• Manage all aspects of operations and ensure efficiency
• Develop and implement strategic plans aligned with company objectives
• Meet financial and performance goals, including budget preparation
Leadership & Team Development:
• Provide vision for call center goals and lead a multi-site team
• Foster a collaborative, employee-focused work environment
• Provide ongoing formal training to team members
• Supervise managers and supervisors to enhance performance
Process Improvement & Analytics:
• Conduct data analysis and present insights to stakeholders
• Establish and monitor key performance indicators (KPIs)
• Implement best practices to optimize effectiveness
• Drive process improvements for scalability and efficiency
Cross-Functional & Client Engagement:
• Manage projects across functions and support corporate initiatives
• Collaborate with departments like clinical, IT,
• Own pharmacy and vendor relationships for claims processing, call routing, reporting, and communication
• Vendor and client-facing as needed
Customer Experience & Service Quality:
• Foster a customer-centric culture and enhance customer satisfaction
• Oversee call center operations, ensuring service quality and adherence to metrics
• Implement strategies for customer loyalty and consistency in messaging
Experience & Industry Knowledge:
• 5+ years in healthcare-related operations roles
• Preferred knowledge of Pharmacy Benefit Management (PBM) operations and industry
Strategic & Leadership Skills:
• Strong strategic thinking and problem-solving abilities
• Ability to prioritize work for cross-functional teams
• Excellent people leadership skills with servant leadership attributes
Technical & Operational Expertise:
• Proficiency in Microsoft Office, email, and internet tools
• Experience in Call Center Software Management
• Expertise in Operations Team Management
Communication & Interpersonal Skills:
• Strong verbal and written communication, presentation, and negotiation skills
• Ability to engage with stakeholders effectively
Additional Requirements:
• Willingness to travel as needed to meet goals
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