Manager, Payer Operations

POSITION SUMMARY:

The Manager, Payer Operations is responsible for managing the deliverables defined by management of the payer operations department, this would include payer accounts management, accurate and timely completion of cases, payer account setup and audit. This role works collaboratively across departments to provide a continuous improvement philosophy around the medical funding customer experience, with an eye for improving productivity in Salesforce and other applications used by the department to facilitate workflow.

POSITION RESPONSIBILITIES:

Develop, implement, and guide the Payer Operations team in the delivery of key metrics, and evaluate productivity to meet or exceed both internal and external customer expectations.

Ensure department goals are in alignment with corporate goals and demonstrate the ability to translate broader company strategy into deliverables for the Payer Operations team.

Hire, train and provide daily direction and coaching to the Payer Operations team, emphasizing the Listen, Learn and Lead philosophy of the Medical Funding Operations department.

Seek, recommend, and assist in the development of technical solutions that improve the speed and accuracy of responses for client files.

Collaborate with all members of Medical Funding staff to ensure a successful medical funding process and a focus on continuous improvement and compliance with HIPAA and FRPA regulations.

Collect and maintain required data to ensure the integrity of medical information for process improvement and auditing purposes.

Consistently demonstrate and advocate for the Listen, Learn and Lead philosophy of the medical funding department, as well as the AbleNet Guiding Principles and 7 Rules of Engagement.

Other duties as assigned.

CORE COMPETENCIES, SKILLS & ABILITIES:

Strong understanding of medical funding process and insurance processes.

Excellent team management skills.

Analytical mindset with the ability to interpret and leverage data in executing on business strategy.

Proven cross-functional collaboration with a focus on continuous improvement and best outcomes.

Computer literacy and demonstrated ability to learn and adapt new technology into daily processes.

Ability to work effectively while multi-tasking and under pressure.

POSITION REQUIREMENTS:

Education & Experience

• Bachelor's degree in business, management, or other related field
• 5+ years of experience within clinical settings, insurance organizations, and other medical professionals
• 5+ years of experience in people-leadership roles
• 3+ years of experience in managing a department
• SalesForce experience preferred

Physical, Time, Presence & Other Requirements

Physical:

Standard Office Environment: Work is performed in an office environment and requires the ability to operate standard office equipment and keyboards.

Time:

Full-Time, Exempt employees work an average of 40 hours per week. Additional hours may be required as necessary.

Presence:

Flexible: This role can be performed in a fully onsite, fully remote, or hybrid capacity.

Other:

Up to 10% travel may be required of this role.