Health Insurance Operations Director jobs in Portland, ME

Health Insurance Operations Director directs and oversees health insurance operations programs in multiple service areas, including account installation, implementation, client support, contract administration, claim processing, and enrollment and eligibility. Manages vendors assigned to each operation. Being a Health Insurance Operations Director resolves issues within each service area. Has deep knowledge of health insurance operations. Additionally, Health Insurance Operations Director typically requires a bachelor's degree of business administration or its equivalent. Typically reports to top management. The Health Insurance Operations Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. To be a Health Insurance Operations Director typically requires 5+ years of managerial experience. (Copyright 2024 Salary.com)

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Director Perioperative Business Operations
  • Covenant Health
  • Lewiston, ME FULL_TIME
  • Position Summary: 

    Under the supervision of the System Vice President of Perioperative Services – Covenant and the Vice President of Patient Care Services – St. Mary's Healthcare, is responsible for the coordination of clinical services for the Operating Room and Sterile Processing Department.  Assures the mission, philosophy, goals, and policies of the organization and nursing department are implemented. In collaboration with the Vice President of Patient Care Services and others, when appropriate, plans, organizes, directs, and coordinates nursing services to meet licensing and accreditation requirements. 

     

    Education/License:

    • Bachelor's Degree in a related field.

    Experience:

    • More than 5 yrs as Director of an intermediate size surgical services division.

    Position Competencies:

    • Coordinates daily staffing patterns to insure appropriate skill mix, numbers and competency for a 24-hour day.
    • Assesses the educational needs of staff and develops an education plan to address identified needs.  Participate in educational activities when appropriate.
    • Interviews, hires, counsels, evaluates performance and/or discipline according to nursing and hospital policy.
    • Accountable for efficient use of all resources: personnel, equipment, finances.
    • Monitors quality of care through data review, observation, patient, physician and staff in-put.  Is accountable for outcome measurement and management.
    • Work collaboratively with others to solve problems and to achieve desired outcomes.
    • Dealing with high-risk variances and patient care issues.
    • Participate in professional organizations as appropriate.  Maintains proficiency.
    • Promotes and participates in community activities to facilitate public awareness of hospital and nursing services.
    • Collaborates with all departments, internally and externally, as well as physician offices and other institutions, to promote an integrated healthcare delivery system.
    • Serves on hospital and nursing committees as designated.
    • Responsible for the day-to-day operations of the Sterile Processing Department, ensuring that all policies and procedures are followed, staff are proficient and patient safety and quality are maintained at all times.
    • Exhibits flexibility and the ability to effect change in the changing healthcare environment.
    • Meets regularly with a surgical services chief to directly market surgical services to physicians and achieve market share growth.
    • Plans and effects capital equipment acquisitions over short and long range periods.  Monitors achievement of planned increases in utilization based on capital acquisition and marketing efforts.
    • Maintains and provides statistical database to the Vice President of Patient Care Services which substantiates human resource allocation and operating time utilization and inpatient/outpatient numbers of surgeries/procedures in an agreed upon format. 
    • Reviews, designs, and implements nursing policies and procedures to establish and maintain a safe environment for all surgical patients.
    • Foster the establishment of subspecialty operating room teams and back up teams to effect delivery of varied services.
    • Maintains the educational skill level of all staff in the most currently practiced and upcoming surgical/diagnostic services.
    • Establishes a mechanism for meeting ongoing staff development.  All educational efforts must foster optimal attitudes and communication skills in all staff members.
    • Assures compliance with state licensing, JCAHO, and regulatory (OSHA, etc.) agency rules and regulations for all assigned areas.
    • Plans for future direction and improvement of the department to keep pace with the changes in medicine and technology.
    • Manages difficulties which influence efficient operations of the area and other related areas.
    • Prepares an annual budget in collaboration with the Vice President of Patient Care Services.  Responsible for operating within its limits and within hospital limits, flexing staff up and down as appropriate.  Review financial expenditures.  Authorizes purchase of supplies and equipment.
    • Supervises all administrative functions of supervisors in assigned areas.  Determines personnel requirements for the department in collaboration with the supervisors.
    • Resolves conflicts between personnel.
    • Works collaboratively with the Vice President of patient Care Services and Quality Management to resolve unanticipated events in the best interest of patients, providers and the organization.
    • If there is a need, we may function in the various staff roles within the departments to help cover.

    Covenant Health Mission Statement

    We are a Catholic health ministry, providing healing and care for the whole person, in service to all in our communities.

     

    Our Core Values:

    •Compassion

    We show respect, caring and sensitivity towards all, honoring the dignity of each person, especially the poor, vulnerable and suffering.

     

    •Integrity

    We promote justice and ethical behavior, and responsibly steward our human, financial and environmental resources.

     

    •Collaboration

    We work in partnership, dialogue and shared purpose to create healthy communities.

     

    •Excellence

    We deliver all services at the highest level of quality, while seeking creative innovation.

     

    Applicants, employees and former employees are protected from employment discrimination based on race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age (40 or older), disability, and genetic information (including family medical history).

  • 1 Month Ago

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Director, Operations
  • Opportunities
  • Scarborough, ME FULL_TIME
  • Join UCT and be part of the fastest-growing sector in the world! We indirectly touch every semiconductor chip that goes into every smartphone, smart car, and device that uses artificial intelligence. ...
  • 6 Days Ago

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(PWM) Part Time Ramp Agent
  • OPERATIONS - Operations
  • Portland, ME PART_TIME
  • Key responsibilities Lift baggage, boxes, or cargo weighing up to 70 lbs. throughout your shift May require lifting over 100 items for a single aircraft Push/pull loaded and empty carts during loading...
  • 16 Days Ago

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(PWM) Part Time Customer Service Agent
  • OPERATIONS - Operations
  • Portland, ME PART_TIME
  • Key responsibilities Greeting passengers and providing a seamless check-in and ticketing experience Use appropriate reservation/ticketing software to rebook itineraries, issue boarding passes, calcula...
  • 18 Days Ago

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Director of Finance and Operations
  • IntWork
  • Portland, ME FULL_TIME
  • IntWork's client, a quasi-governmental organization in Maine, is seeking a Director of Finance & Operations who will provide leadership and expertise with the primary responsibility of planning, direc...
  • 19 Days Ago

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Executive Director of Operations
  • Bay Square at Yarmouth
  • Yarmouth, ME FULL_TIME
  • If you are a driven, dedicated and goal-oriented individual with strong emotional intelligence and several years of management or healthcare experience, then join our team at Benchmark Senior Living! ...
  • 1 Day Ago

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0 Health Insurance Operations Director jobs found in Portland, ME area

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Travel Registered Nurse RN Operating Room OR
  • OneStaffMedical
  • PORTLAND, ME
  • We. Are. OneStaff. Medical. An independently - owned, nationally - recognized and amazingly awesome staffing firm ready ...
  • 4/26/2024 12:00:00 AM

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Assistant Director
  • Youth Advocate Programs
  • Westbrook, ME
  • Status: Full Time SalaryFLSA Classification: Exempt Summary of Position: This Assistant Director position is responsible...
  • 4/26/2024 12:00:00 AM

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Center Manager
  • Csl Plasma
  • South Portland, ME
  • CSL Plasma Center Manager South Portland , Maine Apply Now The Center Manager reports to the Associate Director Operatio...
  • 4/24/2024 12:00:00 AM

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Senior Civil Engineer
  • Main-Land Development Consultants, Inc.
  • Falmouth, ME
  • Do you feel like there should be more to your work and career? Do you seek balance between career and family goals? Do y...
  • 4/24/2024 12:00:00 AM

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Travel Registered Nurse RN Operating Room OR
  • OneStaffMedical
  • PORTLAND, ME
  • We. Are. OneStaff. Medical. An independently - owned, nationally - recognized and amazingly awesome staffing firm ready ...
  • 4/23/2024 12:00:00 AM

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Leadership and Legacy Gift Officer
  • Waynflete
  • Portland, ME
  • Waynflete School, a non-profit, independent day school in Portland, Maine, has been home to families seeking an extraord...
  • 4/23/2024 12:00:00 AM

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TEMP- Payroll Clerk
  • UCare Staffing, LLC
  • Long Island, ME
  • JOB TITLE:TEMP Payroll Clerk FACILITY LOCATION: Long Island, NY REPORTS TO: Accounting Supervisor SUMMARY/OBJECTIVE UCar...
  • 4/23/2024 12:00:00 AM

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General Manager
  • HMSHOST
  • Portland, ME
  • With a career at HMSHost, you really benefit! We offer: Health, dental and vision insurance Generous paid time off (vaca...
  • 4/22/2024 12:00:00 AM

Portland is a city in the U.S. state of Maine, with a population of 67,067 as of 2017. The Greater Portland metropolitan area is home to over half a million people, more than one-third of Maine's total population, making it the most populous metro in northern New England (an area comprising the states of Maine, New Hampshire, and Vermont). Portland is Maine's economic center, with an economy that relies on the service sector and tourism. The Old Port district is known for its 19th-century architecture and nightlife. Marine industry still plays an important role in the city's economy, with an a...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Health Insurance Operations Director jobs
$171,116 to $230,765
Portland, Maine area prices
were up 1.6% from a year ago