General Manager - Healthcare Operations - BPO

PROCESS: Claims handling/Membership enrollment/Provider operations (Credentialing/Provider data management/Benefit configuration/Coding) healthcare Operations from BPO only

JOB TITLE: General Manager

ROLE: Overall Supervision of a business unit which includes Operations Management, Client Management & Budget Management. Unit can consist of anywhere from 150-500 FTEs.

ESSENTIAL QUALIFICATION :

- Should be a Full time graduate

- Knowledge and work experience with ICD9, CPT and HCPCS coding systems (preferable)

- At least 12 Years of Call Center/BPO experience which includes 12 years of Supervisory experience.

- Supervise others by assigning/directing work; conducting employee evaluations; staff training and development; coaching and counseling.

- Effective oral and written communication skills.

- Ability to assess and coordinate departmental workflows effectively.

- Experience in and understanding of Healthcare BPS.

PREFERRED QUALIFICATION

- Should have both Voice and Data Experience

ESSENTIAL SKILLS/PERSONALITY TRAITS:

- Good Communication Skills - Both Verbal and Written.

- Eye for Details.

- Logical thinking.

- Analytical Skills.

- Professional demeanor.

- Ability to work with limited supervision.

- Ability to multi-task and manage time efficiently under the pressure of deadlines.

- Sensitivity to the confidential nature of the data and proprietary company information.

- Good Leadership skills (Leader without Title).

OPERATIONAL RESPONSIBILITY:

- Acts as the customer point of contact/liaison regarding operational issues, including provider meetings, claims issues, projects and ad hoc operational sessions. Implements policy changes as needed to ensure continuing client focused operational responses.

- Responsible for internal and customer initiated audits and regulatory reviews. Interfaces with customers on issues of contracting, network development, operational functions, research and analysis of client/provider issues.

- Tracks progress, follows up on audit results and ensures changes/recommendations are initiated.

- Responsible for meeting established contractual operational standards, departmental standards, goals and deadlines.

- Reviews and analyzes reports, records and directives and confers with DGM's to obtain data required for planning. Establishes procedures for maintaining high standards of operations, product and specific-focus on quality.

PERFORMANCE STANDARDS:

MEASURABLE

- Meeting all Operational Metrics ( Client & Internal)

- Profitability

NON MEASURABLE:

- Self-motivation

- Ability to work un-supervised

- Team Player

- Reliability

- Professionalism

- Achievement orientation

- Relationship building ability

- Personal grooming and etiquette

- Going out of the way to satisfy the external customer

- Initiatives