BHM Healthcare Solutions
  • 24-Jul-2019 to 22-Sep-2019 (EST)
  • Tampa, FL, USA
  • $85,000 to $125,000
  • Salary
  • Full Time

Healthcare Insurance, 401k Plan, Paid Holidays


Location:  Tampa, Florida

Salary:     $85,000-$125,000 Annually.  Compensation is commensurate with level of experience.

BHM Healthcare Solutions, Inc. (BHM) is seeking a Director of IRO Operations to join our Behavioral Health and Medical Review services organization. BHM provides behavioral health and medical independent review services and performance improvement consulting to health plans, providers, ACOs, TPAs, workers' compensation, and other insurers nationally.

The ideal candidate has these key attributes:

  • Experience in customer service management, including but not limited to, staff performance metrics, workflow analysis and process improvement.
  • Development and management of quality assurance programs.
  • Oversight of order fulfillment processing.
  • Experience in physician network management.
  • Outstanding communication skills both verbally and written.
  • Strong ability for multi-tasking in fast paced, ever changing environment.
  • Demonstrated excellent technical abilities, including proficiency with Microsoft Office software, including Word, Excel, and Outlook.
  • Excellent organizational and leadership abilities
  • In depth knowledge of diverse business functions and principles
  • Working knowledge of data analysis and performance/operation metrics
  •  

Responsibilities include, but are not limited to:

  • Liaise with superior to make decisions for operational activities and set strategic goals
  • Plan, monitor and provide daily oversight of IRO Operations, Credentialing and Physician Network Relations to maximize operations, improve productivity and create ongoing efficiencies
  • Develop and maintain department policies, procedures
  • Evaluate overall staff and departmental performance by gathering, analyzing and interpreting data and metrics
  • Manage staff scheduling to ensure operational coverage
  • Provide oversight of customer service level requirements, including but not limited to, call center phone statistics, order fulfillment and quality measures
  • Responsible for development, implementation of quality customer phone and email communications to enhance client satisfaction
  • Coach, train and develop clinical and customer service staff
  • Conduct quality management audits on customer service staff, operations
  • Ensure quality assurance of final documentation of peer reviews prior to submission to client
  • Evaluate regularly the efficiency of business procedures according to organizational objectives and apply improvements
  • Oversee customer support processes and organize them to enhance customer satisfaction
  • Ensure that the company runs with legality and conformity to established regulations
  • The candidate will be available after-hours and weekends for IRO operational support
  • Other related duties as assigned
  •  

QUALIFICATION REQUIREMENTS

  • Minimum Education: BSc/BA in business administration or relevant field; MSc/MA will be a plus
  • Proven experience as Director of Operations or equivalent position
  • Experience with processing clinical peer reviews for Utilization Management program.
  • Prior experience supervising staff.

For more information about BHM, visit www.bhmpc.com.

 

BHM Healthcare Solutions
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