Svp Eligibility, Provider Operations (Bpo)

Under direction of the EVP, the SVP – Eligibility & Enrollment is responsible for the overall viability, effectiveness and operational efficiency of the Eligibility Services division.

Foundation Knowledge, Skills, and/or Abilities Required: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Essential Duties and Responsibilities:

Planning Responsibilities:

• Maintain positive working relationships with existing and new clients with a constant focus on premier customer service in a growth-oriented environment.
• Responsible for supporting new business to achieve company business growth targets. This will include supporting the sales and strategic account leadership and individual contributors through client interactions, implementations, setup and delivery of services.
• Assess operational workflows on an ongoing basis to ensure productivity of resources
• Provide leadership and direction to the Regional VPs and corresponding management teams to ensure effectiveness of operations.

Organising Responsibilities:

• Assist and direct the RVPs, AVPs and Directors in establishing quality improvement programs to ensure consistent and effective client results.
• Represent the Company publicly by maintaining membership in professional associations and attending regular meetings.
• Advise and make recommendations to the EVP on cost containment initiatives.
• Ensure that products, services, and functions are in compliance with all Federal, State, and local regulatory requirements.
• Maintain knowledge of respective state eligibility requirements, public assistance / social services programs, and payer reimbursement requirements.

Controlling Responsibilities

• Maintain adequate and appropriate staffing patterns with proactive flexing relative to client needs and volumes.
• Attend regular review meetings with hospital management to maintain rapport and ensure client satisfaction.
• Review monthly client history analyses, regional and client-based profitability reports and various other statistical and performance reports; and make necessary operational changes to maximize overall Company viability.
• Provide monthly reports and a summary of operational performance to the Executive Vice President.
• Maintain staff compliance with Company policies and procedures; coordinate risk management and personnel issues with Human Resources.

Supervisor Responsibilities

• Supervise team of Regional VPs, AVPs, Directors and Managers
• Conduct regular communication meetings with regional management team members to provide operational updates.

Culture Setting and Leadership Responsibilities

• Represent organisation to clients, prospective clients, and other external parties, as necessary during the course of employment, so as to enhance the image of the Company.
• Create and maintain a viable working relationship with employees and management staff that allows for accomplishing the desired goals of the Company on a timely basis.

Additional Duties and Responsibilities:

• Maintain awareness of and actively participate in the Corporate Compliance Program
• Adhere to prescribed policies and procedures as outlined in the Employee Handbook and the Employee Code of Conduct
• Assist with other projects as assigned by management
• Maintain confidentiality of company, client and patient information at all times

Educational/Vocational/Previous Experience Recommendations:

· A minimum of 15 years operations experience in a large healthcare system or related industry service provider

· Demonstrated accomplishments in leadership with a results-oriented philosophy

· Strong project management and analytical abilities

· Proven written and verbal communication skills

· Experience in public speaking and business presentations

· Bachelor’s Degree in Business or related Finance Discipline, or the equivalent experience

· Extensive financial and operations management experience in a regional and/or corporate environment

Working Conditions:

• For Remote Work from Home - must have a quiet, private area to perform work

• Some travel may be required