Manager, Health Services Operations-PCHP

Interested in a career with both meaning and growth? Whether your abilities are in direct patient care or one of the many other areas of healthcare administration and support, everyone at Parkland works together to fulfill our mission: the health and well-being of individuals and communities entrusted to our care. By joining Parkland, you become part of a diverse healthcare legacy that's served our community for more than 125 years. Put your skills to work with us, seek opportunities to learn and join a talented team where patient care is more than a job. It's our passion.

Primary Purpose

Parkland Community Health Plan's (PCHP's) Manager, Health Services Operations is responsible for the non-clinical aspects of the day-to-day operations in the Health services division. Provides leadership, direction, and administration of operations to ensure accomplishment of organizational objectives. Responsible for managing the Health Services operations including staffing, training, and strategy.

Minimum Specifications

Education

• Bachelor's degree is required.

Experience

• Five years of experience of relevant client services, and operations management.
• Two years of experience in a supervisory or management position.
• Experience in healthcare administration (i.e., clinic operations, clinical research, clinical coordinator, healthcare project management.) is preferred.
• Account management experience is preferred.

Equivalent Education and/or Experience

• May have an equivalent combination of education and experience to substitute for the education requirements.

Skills or Special Abilities

• Knowledge of regulations related to Medicaid and commercial insurance.
• Knowledge of performance measurement systems and metrics.
• Experience in hiring, supervision, and performance reviews.
• Knowledge of HIPAA.
• Strong customer service, problem solving and multitasking skills.
• Excellent skills in writing policies and procedures.
• Professional communication skills including email, telephone, and video conference.
• Ability to communicate professionally with clinicians, nurses, allied health staff, governmental agencies, members, and their families.
• Demonstrated ability to perform effective active listening skills to empathize with the customers in order to develop trust and respect.
• Strong leadership skills and the capacity to contribute to building a team focused on high quality customer service.

Responsibilities

• Supervises day to day non-clinical operations for the health services division including intake, review, and disposition of cases to appropriate clinical team.
• Ensures member satisfaction by troubleshooting when there is a complaint and develops process improvements to prevent recurrences.
• Ensures regulatory compliance with HIPAA, NCQA, HHSC contract requirements and TDI.
• Coordinates logistics for internal and external meetings and conferences.
• Ensure staffing is appropriate for day-to-day operations and problem solve any deficiencies.
• Works collaboratively with the clinical team to ensure the operations aligns with the guidelines of the Health Services department.
• Participates in audits of staff to ensure compliance with regulations, standards, and departmental policies.
• Ensures team meets established performance metrics, performance guarantees, and quality standards.
• Coordinates staff meetings for administrative staff.

Job Accountabilities

1. Identifies and analyzes the design of jobs, work processes, workflows, etc. for the area and implements appropriate changes to improve effectiveness, productivity, and efficiency that support the overall goals of PCHP.
2. Stays abreast of the latest developments, advancements, and trends in the field by attending seminars/workshops, reading professional journals, actively participating in professional organizations, and/or maintaining certification or licensure. Integrates knowledge gained into current work practices.
3. Maintains knowledge of applicable rules, regulations, policies, laws, and guidelines that impact the area. Develops effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and customer requirements. Seeks advice and guidance as needed to ensure proper understanding.
4. Develops and monitors annual budgets that ensure the department has the necessary funds to carry out the goals and objectives that have been established for the department.
5. Develops, implements, monitors, and revises annual goals and objectives for the department that support the missions and objectives of PCHP.
6. Selects, trains, schedules, motivates, supervises, and evaluates employees making recommendations for disciplinary actions up to and including termination, to ensure maximum utilization of individual and group capabilities. Ensures that assigned employees receive opportunities to further their knowledge.

Parkland Health and Hospital System prohibits discrimination based on age (40 or over), race, color, religion, sex (including pregnancy), sexual orientation, gender identity, gender expression, genetic information, disability, national origin, marital status, political belief, or veteran status.As part of our commitment to our patients and employees' wellness, Parkland Health is a tobacco and smoke-free campus.