Director of Out of Network Solutions

Role Overview

This position is responsible for planning, directing, and coordinating all aspects of the department to ensure savings preservation and growth, service of all assigned business clients, and the effective communication of the Company’s solutions to existing and prospective business partners.

What You Will Do

Direct management of performance, develop and implement goals and objectives, compile and analyze trends, manage departmental and team budgets, provide direction and guidance to staff, and ensure compliance with HIPAA regulations.

Why It Might Be a Fit

The ideal candidate will have a minimum of 7 years experience in the healthcare industry with a minimum of 4 years in a leadership role with people management responsibilities, and a Bachelor’s degree in healthcare, business, marketing, or a related field.

Requirements

• Minimum Bachelor’s degree in healthcare, business, marketing, or related field
• Minimum 7 years experience in the healthcare industry with a minimum of 4 years in a leadership role with people management responsibilities
• State licensure certification, including NY Health and/or P&C State Adjustor license, may be required
• Knowledge of provider billing and collection practices
• Knowledge of effective negotiations principles
• Knowledge of commonly used medical coding systems
• Knowledge of commonly used medical data resources
• Knowledge of HCFA-1500 and UB-92 medical claim forms
• Knowledge of Worker’s Comp, Auto Medicare, and Government sponsored programs (such as Medicare or Medicaid)
• Communication, managerial, interpersonal, organizational, time management, customer service/sales, problem solving, leadership, strategic, analytical, tactical and execution skills
• Ability to prioritize and manage time
• Ability to manage various teams
• Ability to make decisions using limited or incomplete data
• Ability to manage multiple projects at the same time
• Ability to use software, hardware, and peripherals related to job responsibilities, including advanced proficiency with MS Office

Benefits

• Equal consideration to all employees and job candidates without regard to sex, age, race, marital status, sexual orientation, religion, national origin, citizenship status, physical or mental disability, political affiliation, service in the Armed Forces of the United States, or any other characteristic protected by federal, state, or local law

Originally posted on Himalayas