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. Their responsibilities would include management of any Operations team.
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
Essential Background Requirements
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
Education: Bachelor's degree in business, accounting, or related areas preferred
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