Network Operations Manager (HYBRID)

Essential Functions:

• Oversee and has direct accountability for network operations including management of the social care network operations, social care network performance issues, and staff management. Ensures resolution of escalated issues related, but not limited to, claims reporting or payment, contract interpretation and parameters, or social care service delivery.
• Monitor and ensure the social care network meets network adequacy requirements, making necessary adjustments to meet regulatory standards. This includes coordination of initial capability assessments as well as network adequacy assessments as defined by Social Care Network program requirements.
• Responsible for establishing and maintaining social care network operational workflows with healthcare ecosystem partners including screening, determination of service eligibility, referrals and health related social needs services. Facilitates documentation of network management standards and processes.
• Ensures the social care network meets established thresholds for access and timeliness of services as defined by NYS Department of Health requirements for Social Care Networks.
• Partner with other entities on individual cases and population health initiatives to improve engagement and outreach to target populations related to social care.
• Supports the Social Care Network Director in timely completion of monthly/quarterly reports for the Department of Health as well as other misc regulatory reports as necessary.
• Ensures alignment of SCN operations with the key elements of NYS’s Social Care Network model.
• Monitors performance, develops and implement business solutions to address process and quality gaps, and communicates network strategy and planning to Stakeholders (internal and external). Develops and reports on goals and objectives related to efficiency and quality of social care services.
• Manages contract performance and supports the development and implementation of value based contract relationships in support of business strategies.
• Identify issues, trends, and opportunities to improve efficiency and/or quality, or to better collaborate with departments and organizations providing services in the social care network.

MINIMUM REQUIREMENTS:

• Education: Bachelor’s degree required or minimum 5 years’ experience in healthcare setting requiring routine interaction with internal and external stakeholders and program management responsibilities.
• Ability to organize, plan, direct and manage medium to large scale, complex, cross-functional, multi-departmental programs to completion with minimal supervision; able to manage multiple concurrent initiatives and effectively prioritize in a dynamic environment.
• Excellent communication skills including the ability to express oneself clearly and concisely.
• Proficient in adapting to changing situations and efficiently alternating focus between tasks to support department operations as dictated by business needs.
• Ability to assume responsibility and exercise good judgment when making decisions within the scope of the position. Utilizes critical thinking skills.
• Ability to think and work effectively under pressure; ability to effectively serve customers; decision making, maintain a concentrated level of attention to information communicated in person and by telephone throughout a typical workday; attention to detail.
• Experience leading development of proactive and effective provider relations.
• Experience collaborating with teams, vendors, partners, and other key stakeholders with the ability to develop strong working relationships.
• Results-driven and client-focused.
• Skilled with personal computer programs such as Microsoft Outlook, Microsoft Office (Word, Excel, Powerpoint, etc.)
• Facilitation of meetings either in person or via virtual platforms such as Zoom.

WORK ENVIRONMENT:

Care Compass Network utilizes a hybrid work model where employees are able to work remotely from a home office or from the CCN office, a non-clinical professional office setting. There may be some travel required for partner and/or network meetings.

BENEFITS:

• Outstanding benefits package (Medical, Dental and Vision, plus much more!)
• 401(k) with match
• Competitive wages
• 14 paid holidays, paid time off (vacation, personal and sick time)