Health Insurance Operations Manager manages and maintains daily health insurance operations in multiple service areas, including account installation, implementation, client support, contract administration, claim processing, and enrollment and eligibility. Handles and settles complicated customer service issues which can not be resolved by lower level staff. Being a Health Insurance Operations Manager monitors performance of each service area. Requires a bachelor's degree or its equivalent. Additionally, Health Insurance Operations Manager typically reports to senior management or Director. The Health Insurance Operations Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Extensive knowledge of department processes. To be a Health Insurance Operations Manager typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required. (Copyright 2024 Salary.com)
Dignity Health Medical Foundation established in 1993 is a California nonprofit public benefit corporation with care centers throughout California. Dignity Health Medical Foundation is an affiliate of Dignity Health - one of the largest health systems in the nation - with hospitals and care centers in California Arizona and Nevada. Today Dignity Health Medical Foundation works hand-in-hand with physicians and providers throughout California to provide comprehensive health care services to the many communities we serve. As Dignity Health Medical Foundation continues to grow and establish new premier care centers we provide increasing support and investment in the latest technologies finest physicians and state-of-the-art medical facilities. We strive to create purposeful work settings where staff can provide great care while advancing in knowledge and experience through challenging work assignments and stimulating relationships. Our staff is well-trained and highly skilled qualities that are vital to maintaining excellence in care and service.
Dignity Health Medical Group – Bakersfield a service of Dignity Health Medical Foundation has four convenient locations in Bakersfield. Along with our local affiliated Dignity Health hospitals (Memorial Hospital Mercy Hospital Downtown Mercy Hospital Southwest) we offer an integrated care delivery system that provides high quality compassionate care in family medicine internal medicine and OB/GYN.
The Manager will oversee both a Surgical clinic as well as a Primary Care clinic.
Position Summary:
The Manager, Clinic Operations is expected to provide visionary leadership to maximize the effectiveness of all service delivery systems, financial performance. Engages staff and cultivatea a care center culture that prioritizes humankindness and patient-centric care consistent with Dignity Health and the medical group's 'way' and culture. Effectively manages all operational aspects of the assigned care center(s). Works closely with staff and providers to ensure that all fiduciary and care center goals are met. Proactively determines workload priorities through planning, coordination and managing staff and providers to meet the care center's administrative, operational and support requirements.
This position will also have access to patient protected health information (PHI). The Manager, Clinic Operations has a responsibility to safeguard patient health and financial information.
Minimum Qualifications:
- Minimum of three (3) years of healthcare management experience.
- Bachelor's degree in business, finance or healthcare administration or related field, or equivalent combination of experience and education.
- Demonstrated ability to effectively lead productive, engaged teams and work with providers.
- Knowledge of business and management principles, budget control and accounting principles, including capital budgeting, cost accounting, professional and patient billing; and ability to apply these principles to a health care environment.
- Knowledge of or ability to learn the budgeting process, management reports, accounting, purchasing and patient billing systems.
- Knowledge of computers, systems and software, including word processing, spreadsheet, data base, clinic information systems, electronic medical records, billing systems, and other application packages.
- Health insurance knowledge of HMO, PPO and capitated risk plan contracts as they relate to providers and practices.
Preferred Qualifications:
- Previous out-patient practice & healthcare management experience preferred.
- Previous management experience in a union environment preferred.
- Prior managed care or integrated delivery systems experience preferred.
- Master's degree in business, finance or healthcare administration or related field preferred.
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