Mgr Business Operations

JOB SUMMARY

This job plans, manages and oversees the implementation of the strategic business and functional infrastructure, continuous process improvement initiatives across multiple functional units, and transformational support to include design throughout implementation to assure people/process/technical solutions align with strategic initiatives while driving consensus among business units. Designs activities including the documentation, management and oversight of end to end workflow process analysis assuring improved productivity, cost effectiveness, appropriate embedding of key performance indicators and appropriate controls for both regulatory and compliance considerations.

ESSENTIAL RESPONSIBILITIES

• Perform management responsibilities including, but not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity. 
• Plan, organize, staff, direct and control the day-to-day operations of the department; develops and implements policies and programs as necessary; may have budgetary responsibility and authority. 
• Oversee the definition, scoping, chartering efforts for business process analysis/design projects related to process improvement initiatives assuring optimal business and functional delivery of the strategic delivery framework.
• Manages the business consultation services which include research, analysis facilitation, process modeling, and business process improvement techniques to propose and implement business and system solutions that meet strategic objectives and compliance requirements.
• Establish and maintain strong working relationships across business unit/area level of management continuing to promote and continually broaden the level of business knowledge and the impact of quality/process improvement projects and programs.
• Oversee planning sessions with business owners to improve business processes and to prioritize and drive process re-engineering initiatives including process ownership and governance.
• Oversee the analytic processes, data points, and controls to determine sub-optimal performance, communicate findings clearly and effectively and make recommendations for improvement. Identify root causes of problems and demonstrate the ability to development and make recommendations for solutions to mitigate root cause.
• Oversee the vendor management relationships with applicable business unit subcontractors assuring compliance with regulatory and accrediting entities and oversees the business unit compliance activities with regulatory and accrediting entities
• Other duties as assigned or requested.

QUALIFICATIONS

Minimum

• High School Diploma or GED
• 5 years' experience in designing and implementing operational processes to make improvements or solve business challenges
• 3 years experience leading projects or managing people.

Substitutions

• None

Preferred

• Bachelor’s Degree
• Six Sigma Black or Green Certification
• 3 years ofmanaged care and/or call center operations experience
• 3 years of Medicaid/Medicare experience
• 3 years of NCQA experience

Skills 

• Thorough understanding of business operations, requirements processes, and business modeling concepts and demonstrated business knowledge required to evaluate corporate-wide implications of changes to products and programs to assess impact for all lines of business
• Software skills, including use of Microsoft Office software and other applications
• Demonstrated and highly proficient verbal communication skills to articulate ideas clearly to various audiences
• Time management, organizational and multi-tasking skills necessary to work in a fast-paced environment
• Teamwork-focused/collaborative work style

SCOPE OF RESPONSIBILITY 

Does this role supervise/manage other employees?

Yes

WORK ENVIRONMENT

Is Travel Required?

Yes            

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.