AF GROUP

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Healthcare General Manager in Seattle, WA at Accident Fund Holdings, Inc

at AF GROUP

Posted: 9/4/2019
Job Status: Full Time
Job Reference #: J3T869687VZ4W46NR52
Keywords: operations

Job Description

Job Description

SUMMARY:

The Regional General Manager is responsible for the daily operations of a specific division including implementation and oversight of successful strategies for revenue maximization for health plans with Medicare Advantage members.

RESPONSIBILITIES/TASKS:

  • Responsible to oversee all ADVANTASURE staff in a specific division.
  • Oversight will include Client Management and Client Reporting utilizing a hands-on approach to working with clients with a focus on improving risk scores, revenue yield, quality of care, and provider engagement.
  • Implementation with new provider locations, day to day operations in provider locations, presentation with potential providers, and troubleshooting issues or concerns.
  • Ensures services provided are as expected, assists in working with physicians to increase knowledge of services provided, and maximizes capture of conditions.
  • Provides Program Analytics to client, which will identify opportunities and improve operational processes, quality of care, and revenue.
  • Builds company image by collaborating with customers, leadership, and employees.
  • Coordinates and conducts on-site quarterly meetings and provider education.
  • Designs provider education that will ensure documentation guidelines, HCC methodology, and quality initiatives.
  • Maintains quality service by establishing and enforcing organization standards.
  • Ensures procedures are implemented which will maximize the interaction between ADVANTASURE staff and the providers and office staff.
  • Clearly communicates the business model and tactics to stakeholders.
  • Provides strategic and tactical initiatives to support improved coding and health care.
  • Evaluates existing and emerging technology and outsourced services to consider the potential utility, acquisition, and implementation options.
  • Creates an environment of continual improvement and adaptive innovation which is responsive to the organizational needs.
  • Assists in recruiting, developing, and retaining staff to support effective participation in their role.
  • Oversees management of personnel, providing recommendations for hiring, promotion, salary adjustment, and personnel action where appropriate.
  • Stays abreast of regulatory requirements and company compliance policies, ensuring timely staff education.
  • Provides vision, leadership, planning, project coordination, and management for the development of a cost-effective department while concurrently facilitating efficient operations to meet current and future business needs within the organization.
  • Represents Company in community and industry, programs and conferences.
  • Upon request, functions as the department head in the absence of the executive leader.
  • Participates in the development of programs as a strategic partner that supports the company plan.
  • Participates in development of annual departmental budget, monitors budget and identifies budget discrepancies. Researches cause and makes recommendations.
  • Responsible for balancing workload to optimize the effectiveness of the department.

DIRECTION EXERCISED:

Directly supervises exempt and non-exempt staff in accordance with company policies and applicable Federal and State Laws. Responsibilities include but are not limited to effectively interviewing, hiring, terminating, and training employees; planning, assigning and directing work; appraising performance; rewarding and counseling employees; addressing complaints and resolving problems; supporting and encouraging the engagement process.

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.