BPaaS Operations Manager – Enrollment and Premium Billing

The BPaaS Operations Manager will be assigned to oversee all aspects of the Enrollment and Premium Billing operational areas for Medicare and Medicaid Clients including planning, organizing, and managing staff and processes to deliver outcomes aligned with operational and contractual commitments. This is a mid-level management position and requires a seasoned professional with outstanding judgment, leadership, communication and interpersonal skills. The position requires strategic thinking, decision-making ability and formal responsibility for meeting business goals. Candidates need strong operational management experience and the ability to monitor and manage multiple client’s outcomes concurrently, as well as demonstrate excellent staff management skills.

Responsibilities:

• Maximize use of the RAM processing platform and surround products to drive automated and efficient manual outcomes
• Develop / maintain department policies and procedures, workflows, handoff processes, etc.
• Prepare formal training approach, timelines, etc. to onboard staff
• Manage day-to-day processes, inventories and operational staff for Medicare and Medicaid clients including the Enrollment Applications, State 834 Enrollment Files, Daily Transaction Reply Reports, Premium Billing, Cash Receipts and COB information, as applicable
• Assess and maximize workflow capabilities
• Coordinate with IT/Ops Support to ensure UAT plans, scenarios and cases align with operational processes and expected results
• Assess reporting needs for responsible functions and determine how best to operationalize a metric driven approach to managing the department and client outcomes
• Assist in ensuring the service offering can tactically be delivered against contractual, regulatory and financial expectations
• Implement a continuous improvement plan to identify opportunities for improvements in technology and process to drive the most efficient outcomes including use of robotic automation
• Develop and maintain sales slides to describe operational process, controls and outcomes. Support sales activities demonstrating depth and breadth of industry knowledge
• Assist with implementationsas needed
• Other duties as assigned

Minimum Requirements

Industry Experience: 7+ years in healthcare industry experience working in the payer segment in Medicare Advantage, Managed Medicaid or working with an industry competitor. BPaaS experience is a plus.

Skills & Knowledge: MS PowerPoint, MS Word, MS Excel, MS Project, MS Access. Exceptional interpersonal, listening, written and oral communication abilities are a must. Candidate must have subject matter expertise with enterprise back office healthcare payer product solutions.

Must possess strong operational management skills as well as the ability to interact directly with internal departments and clients.  Able to oversee and deliver results across multiple clients is also required.

Knowledge of the healthcare industry, BPaaS operations and experience in building scalable operations are pluses.

Years of Experience:  7+ Years

Education: A Bachelors of Science (BS), Bachelors of Arts degree (BA) or equivalent is preferred

Certifications/Licenses: Healthcare industry, IT / Business, consulting or project management certifications a plus.

Travel Requirements: Less than 25% (fluctuates)

References: Two Former Employers (Direct Manager), 1-2 former Clients

Number of Clients Supported: Multiple

Compensation: Competitive salary and benefits

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Salary requirements must accompany resume for consideration.

To apply for this position:

• CLICK HERE and follow directions to “Apply for this Job”

EEO / AA Employer