VP of Operations

VP Healthcare Operations

This position will be located in or around Hershey, PA

• The VP, Healthcare Operations will work in collaboration with Corporate Leadership to provide strategy, oversight and direction for operations. 
• The VP, Healthcare Operations will develop, align and implement practices to optimize efficiencies, increase scalability, allow for growth and deliver a positive customer experience for all stakeholders. 
• Responsibilities include but are not limited to process improvements that are in alignment with strategic plans; providing leadership and management that supports the company’s mission, vision, and core values; and ensures the efficient and compliant delivery of all contracts and services as it relates to operations.

Job Description:

• Provide guidance related to competitive/industryhealthcare trends involving expansion and growth opportunity.
• Provide operational oversight of third party vendors.
• Articulate and engage change throughout the organization as it relates to authorization and billing procedures.
• Leverage technology to streamline efficiencies within the healthcare operations group relating to claim processing, enrollment, and third party management.
• Research and implement new strategies and techniques to ensure the company remains at the forefront of modern practice.
• Create new policies and amend existing policies to improve operations as needed. Present recommendations on the operations of the organization and propose changes to mitigate risk and facilitate future growth.
• Provide personal leadership that encourages employee productivity and responsiveness to the needs of the current and prospective members, providers and regulatory agencies/staff.
• Ensure programs are established to comply with all relevant federal, state and local regulations.
• Ensure management staff maintains focus on efficiency and execution
• Maintains working knowledge and compliance of any local, state, and national regulations identified as regulatory requirement
• Forecast, create, and maintain annual budgets, reviewing on a monthly and quarterly basis
• Promote internal growth and development of leadership staff Experience
• Must possess the ability to assess potential problems and make sound judgment around issues that may have an adverse impact on the company.
• Must be a strategic planner with sound technical skills, analytical ability and strong operational focus.
• Must have strong ability to relate to people at all levels of the organization and possess excellent communication and presentation skills, both written and verbal.
• Ability to handle multiple projects, meet deadlines and adapt to changing business environment and/or needs
• Effective leadership and team building skills.
• Implement governing body directives or policies.
• Oversee fiscal management.
• Comply with applicable laws and regulations.
• Monitor quality and appropriateness of services and products and assuring their availability.
• Program planning, development, administration and evaluation.
• Overall administration of Agency and its affiliated companies.
• Coordinate and liaison with appropriate affiliate departments and committees.
• Represent the organization to other groups, agencies, and the general public.
• Keep the governing body and staff informed of current organizational, community, and industry trends.
• Develop policies and guidelines of operations.
• Seek and encourage input from other administrative and service personnel.
• Provide professional input to related administrative systems.
• Participate in the formulation of a business plan strategic goals, resource allocation plan(s) and budgets.
• Consult, plan and work with the Governing Body and Management Staff in policy formulation and program development and implementation including matters of staffing for the Agency.
• Assist the Governing Body in planning activities to develop administrative policies and practices.
• Coordinate with the Administrator and management and program areas for appropriate services operations and administration according to the organizational structure.
• Maintain liaison for data processing and record needs, including weekly, monthly utilization reports.
• Keep the management staff informed of Agency and affiliate developments, needs, etc., and encourages their participation in problem solving at the organization and community levels.
• Submit formal written proposals to the Governing Body for all new programs of Services with complete cost/benefit analysis.
• Direct the implementation of service goals and objectives.
• Consult, plans and works with the Governing Body to implement all support functions relating to Board activities and other committee activities, i.e., agenda, minutes, reports and yearly calendar of activities
• Submit monthly and other operation reports to the Governing Body on a timely basis, outlining the completion of goals and objectives including justification for those not attained.
• Participate in selective conferences and workshops to promote knowledge in community health trends, job performance efficiency and overall professional growth.
• Establish personal goals and objectives for advancement.
• Participate with other health, civic, educational and professional groups as directed.

Qualifications, and Education

• Bachelor’s degree in Business or related field, required; Master’s degree, preferred
• Minimum of eight years’ experience in Healthcare industry, medical or ambulance billing required
• Minimum of five years management experience relating to BPO/TPA type services required
• Mastery of oral, written, presentation and facilitation skills
• Demonstrated experience utilizing MS Office Suiteand project management software
• Working knowledge of medical information systems, medical claims payment process, medical terminology and coding, managed care, and Medicare and Medicaid programs.
• Strong understanding of the current and future state of the healthcare industry.