Director of Operational Support- SPR

Onsite schedule

Responsible for guiding the daily activities of and providing feedback to the VP related to provider enrollment's performance and progress toward meeting KPI's and hitting goals set for the department and in support of the larger financial needs of Carilion Clinic.Critical thinking skills are needed every day in directing the operational areas. Assessing the current situation, what we need the outcome to be and how to get there is required daily to keep provider enrollment working at an optimal level. Responsible for guiding Provider Enrollment functions for a large healthcare organization.

Duties & Responsibilities may include but not limited:

• Applies key financial concepts and analysis to decision making. Use Financial data to drive performance and maintain planning budget.
• Delivers efficient, consistent, and timely services. Recognizes and acts on opportunities for growth and improvement to advance the goals of provider enrollment. Uses project management principles to accomplish goals, seeks out appropriate resources and proactively anticipates change within the market, industry, and healthcare system. Aligns services with the mission and vision of Carilion. Translates Carilion Clinic goals into department specific objectives and priorities, goals, and Key Performance Indicators.
• Gathers and analyzes data, prepares reports and develops and delivers presentations to a variety of audiences in support of business cases, proposed projects, and system requirements.
• Responsible for leading the transition from manual to automated processes across the provider enrollment workflow, ensuring seamless integration and collaboration with intersecting departments.
• Develops, initiates, implements, analyzes, and evaluates the internal and external environment in terms of insurance payer guidelines, technological, regulatory, and financial factors to serve as a resource to both internal and external clients to ensure that strategic planning, process analysis, developmental and implementation plans are optimizing health system needs. Stays abreast of state and federal requirements as it relates to the provider enrollment roles.
• Responsible for identifying operational efficiencies and redundancies within the provider enrollment process and ensuring the implementation of effective, sustainable solutions.
• Responsible for leading provider training "road shows" across clinical areas to educate and explain the end-to-end provider enrollment process, from initial onboarding through payer enrollment.
• Inspires enthusiasm and builds support for projects. Attracts, selects, develops, evaluates, and retains qualified employees. Effectively uses developmental planning to expand employee skills and abilities, and addresses areas for improvement through coaching and or corrective action.
• Provides leadership direction to the Provider Enrollment team.
• Works closely with internal and external business units and other corporate functioning areas, focusing on strategic initiatives as well as development and communication of standards relating to organization-wide policies.
• Responsible for operational budget planning and management.
• Strategic planning, process analysis, developmental and implementation plans.
• Coordinates with both internal and external resources to coordinate excellence in customer services and data integrity.
• Maintain accuracy and timely enrollments with contracted payors, Medicare, Medicaid and private payors to secure access for patients and proper reimbursement for services rendered. Ensures adherence to federal, state, local payor requirements.
• Responsible for operational planning, strategic visioning, process analysis, developmental and implementation plans.

Education: Bachelor's degree in business administration, management or related field required. Master's degree preferred

Experience: 5 or more years' experience in healthcare finance and a minimum of 5 years in Leadership. Extensive Background in Education, Quality Assurance, and Technology Management required.

Licensure, certification, and/or registration: Project Management Certification or Analytics Certification is plus

This is Carilion Clinic ...

An organization where innovation happens, collaboration is expected and ideas are valued. A not-for-profit, mission-driven health system built on progress and partnerships. A courageous team that is always learning, never discouraged and forever curious.

Headquartered in Roanoke, Va., you will find a robust system of award winning hospitals, Level 1 and 3 trauma centers, Level 3 NICU, Institute of Orthopedics and Neurosciences, multi-specialty physician practices, and The Virginia Tech Carilion School of Medicine and Research Institute.

Carilion is where you can make your own path, make new discoveries and, most importantly, make a difference. Here, in a place where the air is clean, people are kind and life is good. Make your tomorrow with us.