Group Health Operations Manager

🕒 Abril 3

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Dane Street

SiteLinkedInTodas as Vagas

51 - 200 funcionários

⚕️ Seguro de Saúde

📋 Conformidade

🏛️ Governo

Healthcare Insurance • Compliance • Government

A Dane Street é líder nacional em Exames e Revisões Médicas Independentes, fornecendo Exames Médicos Independentes (IMEs), Revisões por Pares e outros laudos médicos de forma objetiva, em conformidade e dentro dos prazos. Com uma ampla rede de mais de 16. 000 médicos, a empresa oferece serviços em 25. 000 localidades e 100 especialidades, incluindo sinistros de compensação trabalhista (Workers’ Compensation), automóvel, responsabilidade civil (Liability) e incapacidade (Disability). A Dane Street atende seguradoras, Third-Party Administrators (TPAs), organizações de Managed Care e órgãos federais/estaduais com análises médicas especializadas, ajudando-os a tomar decisões precisas. A empresa é reconhecida pela qualidade, prazos de entrega ágeis e processos eficientes, tendo conquistado credenciais como a Acreditação da NCQA em Utilization Management e a certificação Great Place to Work.

Descrição

• Oversee and ensure the profitability of the regional operations center • Drive revenue growth by delivering excellent customer service • Ensure timely delivery of high-quality reports • Manage client inquiries in a timely manner • Optimize physician costs and ensure adherence to fee schedules • Build relationships with key physicians for panel retention • Monitor key performance metrics of Customer Service Representatives (CSR) and Quality Assurance (QA) Specialists • Conduct performance evaluations and handle discipline as needed • Plan and organize daily activities related to production and operations • Measure productivity by analyzing performance and financial data • Coordinate with other departments such as HR, finance, and IT

🎯 Requisitos

• An Associate’s Degree or Bachelor’s Degree is preferred • RN / LPN License is required • Business experience in a healthcare and/or insurance setting is preferred • Business experience in a Worker’s Compensation and/or Auto insurance setting is preferred • Utilization Review experience is required • Present exceptional communication skills with a clear understanding of company business lines • The ability to apply critical thinking, manage time efficiently and meet specific deadlines • Computer literacy and typing skills are essential

🏖️ Benefícios

• medical, dental, and vision coverage for you and your family • voluntary life insurance options for you, your spouse, and your children • other voluntary benefits including hospital indemnity, critical illness, accident indemnity, and pet insurance plans • basic life insurance, short-term disability, and long-term disability coverage at no cost • generous paid time off policy • 401k plan with a company match • Apple equipment and a media stipend for remote workspace