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)
This leader plans, develops and provides operational oversight and management of quality, practice, policies, and processes to promote quality patient care to ensure consistent best practice standards guide the provision of care for all FPG specialty care offices. In this role, the leader sets the tone and models positive leadership behavior, while ensuring department and division projects and responsibilities are completed successfully in support of organizational goals.
- Require a bachelor's degree in business management, health care administration or related field; or eight (8) years of direct health care experience with demonstration of progressive leadership and continuing education, may be substituted in lieu of degree requirement.- Require a minimum of five (5) years of demonstrated progressive leadership experiences with a minimum of three (3) of those years in a management or executive level role in healthcare (preferably in a sspecialty medical office setting), as well as experience with practice management and electronic medical records software.
Prefer certification in one of the following: American College of Medical Practice Executive (ACMPE) or Certified Physician Practice Manager (CPPM). - Prefer certification in Lean Six Sigma or other process improvement or project management concept.- Prefer experience in HIPAA compliance and regulations, as well as experience with electronic medical record systems, development, reporting, and management.- Prefer proficiency in all Microsoft office products, to include the development and analysis of reports.
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