Health Insurance Operations Director jobs in Reading, PA

Principal Duties and Responsibilities

• Participates in recruitment and retention of professional and gives guidance for the recruitment of non-professional staff.
• Participates in establishment and implementation of organizational policies and procedures.
• Interprets policies, objectives and operational procedures.
• Participates in the deliverance of high quality, patient focused health care.
• Resolves problems related to staffing, utilization of facilities, equipment and supplies for the Center.
• Evaluates performance and recommends merit increases, promotion, and disciplinary actions.
• Analyzes and recommends changes BCHC systems, policies and procedures and ensures their implementation.
• Delegates’ authority and responsibility as appropriate.
• Participates in professional development activities to keep current with trends and practices in health care administration (conferences, journals).
• Oversees the professional staff education, in-service training, and orientation of medical staff
• Presents, facilitates and leads assigned process improvement events using methods of culture-appropriate team building, team energizing, data gathering and analysis, problem solving, and project management.
• Presents, facilitates and leads assigned process improvement events using methods of culture-appropriate team building, team energizing, data gathering and analysis, problem solving, and project management.
• Seeks and evaluates process improvement information, materials, and methods to match specific organizational needs as outlined by management, and adapts them to use in the execution of process improvement events.
• Provides event follow-up to monitor the progress of planned improvement implementation to assure timely action, appropriate management support, and achievement of expected benefits.
• Uses appropriate measurement, analysis and evaluation methods to accurately identify and document process improvements.
• Coordinates with related departments and functions to assure appropriate information flow and understanding of overall process improvement direction.
• Participates and ensures the development of organizational guidelines, policies and procedures in accordance with funding source requirements, as well as State and Federal law.
• Work closely with department managers and quality and risk management to minimize the risk of errors, accidents and other adverse incidents, having a clear and thorough knowledge of medical center policies and procedures.
• Work closely with staff and managers to assess potential risks. Manage potential risks and liabilities within the health center facilities by creating, approving, implementing, and improving policies that improve both patient care and employee safety.
• May take phone calls or receive written patient complaints or accusations. Data is collected and review to identify problems or weaknesses in medical center procedures. May include assisting department managers, and if appropriate, the Director of Human Resources, Compliance to submit reports to the appropriate persons and agencies.
• Undertakes special projects as directed by the COO.
• Evaluates performance, implements corrective action on areas needing improvement or re-training.
• Participates on applicable committees and recommends policy changes as necessary.

Other duties as assigned.
Education and Requirements

• Bachelor's degree in health related field, Masters’ preferred.
• Active Registered Nurse License.
• A minimum of 5 years experience in healthcare operations.
• Must be familiar with operations, quality assurance and regulations.
• Must be current with State and federal rules and regulations for corporate compliance and medical records
• Experience managing Information Technology in a healthcare setting.
• Excellent communication skills.

Job Type: Full-time

Pay: From $95,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Employee discount
• Flexible spending account
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift

Ability to Relocate:

• Reading, PA 19601: Relocate before starting work (Required)

Work Location: In person