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Healthcare General Manager in Seattle, WA at Accident Fund Holdings, Inc
at AF GROUP
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.
- 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.
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.