Director Operations Delivery

Company :

Job Description : 

JOB SUMMARY

This job manages and develops all direct and indirect reports with responsibility for handling inquiries for all states outside of primary area and processing claims submitted by host providers within primary area.  In addition, the incumbent is the Primary contact for all inter-plan programs and related issues and coordinates time-sensitive software implementation and new functionalities.  

ESSENTIAL RESPONSIBILITIES

• Communicate effectively
• Ensure high quality staff are hired for team and provide coaching, mentoring and leadership to team.
• Direct the daily production activities of staff members to deliver accurate, timely and efficient service to Highmark’s customers across a functional area.
• Participate in the formulation and execution of Highmark’s operations strategy and vision for division.
• Contributes and participates in the product management and governance process by identifying and representing client-specific requirements, managing all day-t-day operational defects to resolution and ensure that all performance guarantees are achieved
• Provide significant input and direction to the development of Highmark’s future operational capabilities by investigating and recommending newly defined systems, process and techniques.  
• Other duties as assigned or requested.

EDUCATION

Required

• Bachelor’s degree or relevant experience and/or education as determined by the company in lieu of bachelor's degree

Preferred

• None

EXPERIENCE

Required

• 7 years in a management role
• 7 years in large operations environment
• 7 years of evaluating technology for implementation
• 7 years with insurance products principles, industry practices and processes

Preferred

• 5 years of insurance product knowledge
• 5 years in Workforce Development and Resource Management
• 3 years in Marketing or selling services for operational capabilities
• 3 years with Project Management

LICENSES or CERTIFICATIONS

Required

• None

Preferred

• None

SKILLS

• Excellent leadership skills
• High standard of professional conduct
• Excellent business writing skills
• Ability to maintain confidential information
• In-depth knowledge of call center technologies and methodologies.

Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-based

Teaches / trains others regularly

Occasionally

Travel regularly from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

Lifting: 25 to 50 pounds

Rarely

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range Minimum:

Pay Range Maximum:

Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations.  The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

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For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

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