Current jobs related to Director of Managed Care and Network Operations - Camarillo - Clinicas del Camino Real, Inc.
-
Executive Director
7 days ago
Camarillo, California, United States Atria Senior Living Full timeAbout the RoleWe are seeking a highly skilled and experienced Executive Director to lead our community's day-to-day operations. As a key member of our team, you will be responsible for driving business growth, improving customer satisfaction, and ensuring a safe and healthy work environment.Key ResponsibilitiesLeadership and StrategyDevelop and implement...
-
Director of Customer Operations
6 days ago
Camarillo, United States CALIFORNIA INTERNET L.P. Full timeThe Director of Customer Operations is responsible for leading the customer operations team in providing exceptional service to new and existing customers. As the leader of Field Technicians and installers (in-house and contractor), Tier 1 support, Dispatch, Repair, and Maintenance, the Director will work to ensure that customer commitments are met and...
-
Director of Customer Operations
1 month ago
Camarillo, United States CALIFORNIA INTERNET L.P. Full time $90,000 - $125,000Job DescriptionJob DescriptionDirector of Customer Operations is responsible to lead the customer operations team in providing exceptional service to new and existing customers. As the leader of Field Technicians and installers (inhouse and contractor), Tier 1 support, Dispatch, Repair and Maintenance, the Director will work to ensure that customer...
-
Executive Director
2 weeks ago
Camarillo, California, United States Atria Senior Living Full timeJob SummaryAtria Senior Living is seeking an experienced Executive Director to lead our community's day-to-day operations. As a key member of our team, you will be responsible for driving business growth, ensuring exceptional resident experiences, and fostering a positive work environment.Key ResponsibilitiesStrategic Leadership: Develop and implement sales...
-
Customer Operations Director
2 weeks ago
Camarillo, California, United States CALIFORNIA INTERNET L.P. Full timeJob Description**Job Summary:**We are seeking a highly skilled and experienced Customer Operations Director to lead our customer operations team at California Internet L.P. The ideal candidate will have a strong background in customer operations, leadership, and communication, with a proven track record of delivering exceptional customer service and driving...
-
Senior Operations Manager
2 weeks ago
Camarillo, California, United States Atria Senior Living Full timeJob SummaryAtria Senior Living is seeking an experienced Executive Director to lead our community's day-to-day operations. As a key member of our team, you will be responsible for overseeing the overall performance of the community, including financial management, sales, and resident satisfaction.Key ResponsibilitiesLeadership and Management: Recruit, train,...
-
Director of Accounting
1 month ago
Camarillo, United States GHJ Search and Staffing Full timeJob DescriptionJob DescriptionDirector of Accounting We have partnered with a nonprofit organization located in Camarillo, CA. The accounting team is seeking a Director of Accounting who will be responsible for oversight of the accounting and finance functions of the organization. Reporting to the Chief Financial Officer, this position ensures compliance...
-
Executive Director
2 weeks ago
Camarillo, California, United States Atria Senior Living Full timeJob DescriptionOverviewAtria Senior Living is seeking a highly skilled and experienced Executive Director to lead our community's day-to-day operations. As a key member of our team, you will be responsible for driving business growth, ensuring exceptional resident experiences, and fostering a positive work environment.Key ResponsibilitiesLead Operations:...
-
Practice Manager
2 weeks ago
Camarillo, United States Sound Physicians Full timeAbout the RoleThe Practice Manager is a key member of the Sound Physicians team, responsible for the on-site operational management and support of our physician practice. This role requires a strong understanding of healthcare operations and a ability to work effectively with hospital leadership and staff.Key ResponsibilitiesAct as the front-line liaison for...
-
Senior Branch Network Management Trainee
2 weeks ago
Camarillo, California, United States WELLS FARGO BANK Full timeJob SummaryWe are seeking a highly skilled and experienced Senior Branch Network Management Trainee to join our team at Wells Fargo Bank. As a key member of our Consumer, Small and Business Banking division, you will be responsible for leading, managing, and developing a diverse team of direct and indirect reports.Key ResponsibilitiesCoach, develop, and...
-
Chief Operations Officer
3 weeks ago
Camarillo, California, United States Atria Senior Living Full timeKey Responsibilities The Chief Operations Officer is tasked with overseeing the daily functions of the community, holding full accountability for profit and loss. This role involves strategizing, executing, and assessing all operational facets. The COO is responsible for recruiting and mentoring team members, directly supervising a high-performing leadership...
-
Medicare PBM Senior Operations Manager
3 weeks ago
Camarillo, United States Gold Coast Health Plan Full time $141,750 - $236,250Job DescriptionJob DescriptionThe pay range above represents the minimum and maximum rate for this position in California. Factors that may be used to determine where newly hired employees will be placed in the pay range include the employee specific skills and qualifications, relevant years of experience and comparison to other employees already in this...
-
Executive Director
6 days ago
Camarillo, California, United States Atria Senior Living Full timeJob SummaryAtria Senior Living is seeking a highly skilled and experienced Executive Director to lead our community's day-to-day operations. As a key member of our team, you will be responsible for driving business growth, ensuring exceptional resident experiences, and fostering a positive work environment.Key ResponsibilitiesDevelop and implement sales and...
-
Water Distribution Operations Manager
1 week ago
Camarillo, California, United States City of Camarillo California Full timeJob Summary:We are seeking an exceptional individual to join our Public Works Department, Water Division team as a Water Supervisor. The ideal candidate will possess a background in potable and recycled water distribution operations, demonstrating proficiency in water treatment, distribution, and operations management.Key Responsibilities:Oversee the daily...
-
Client Care Manager
3 weeks ago
Camarillo, California, United States Devoted Care Services Camarillo Full timeJob OverviewBenefits:Performance-based bonusesParental leave optionsOpportunities for training and professional developmentAt Devoted Care Services, we are committed to delivering exceptional support and care to our clients and their families. Our dedicated team of professionals strives to enhance the quality of life through tailored and effective care...
-
Head of Customer Operations
3 weeks ago
Camarillo, California, United States CALIFORNIA INTERNET L.P. Full timePosition OverviewThe Director of Customer Operations at CALIFORNIA INTERNET L.P. plays a pivotal role in steering the customer operations division to deliver outstanding service to both new and existing clientele. This position oversees a diverse team comprising Field Technicians, installers (both in-house and contracted), Tier 1 support, Dispatch, and...
-
Head of Customer Operations
2 weeks ago
Camarillo, California, United States CALIFORNIA INTERNET L.P. Full timePosition OverviewThe Customer Operations Director is tasked with overseeing the customer operations division, ensuring that both new and existing clients receive outstanding service. This role involves leading a diverse team, including Field Technicians, installers (both in-house and contractors), Tier 1 support, Dispatch, and Repair and Maintenance teams,...
-
Head of Customer Operations
3 weeks ago
Camarillo, California, United States CALIFORNIA INTERNET L.P. Full timePosition OverviewThe Director of Customer Operations at CALIFORNIA INTERNET L.P. is tasked with steering the customer operations division to deliver outstanding service to both new and existing clientele. This role encompasses leadership over Field Technicians, installers (both in-house and contracted), Tier 1 support, Dispatch, as well as Repair and...
-
Director of Sales and Marketing for Senior Care
2 weeks ago
Camarillo, California, United States Oakmont Management Group Full timeJob Title: Sales and Marketing DirectorOakmont Management Group, a leading provider of senior living communities, is seeking a highly motivated and experienced Sales and Marketing Director to drive sales growth and develop strategic marketing plans.Key Responsibilities:Develop and Implement Marketing Strategies: Create and execute effective marketing plans...
-
Culinary Services Director
2 weeks ago
Camarillo, California, United States Atria Senior Living Full timeAbout the RoleWe are seeking a highly skilled and experienced Culinary Services Director to join our team at Atria Senior Living. As a key member of our community, you will be responsible for overseeing the day-to-day operations of our kitchen and dining venues, ensuring that our residents receive exceptional culinary experiences.Key...
Director of Managed Care and Network Operations
4 months ago
Quality Care Starts At Clinicas
This is an excellent opportunity to work for an organization that truly makes a difference in the community. Clinicas Del Camino Real, Inc. offers a highly competitive salary; excellent benefit package including full medical, dental, vision, life and disability insurance; generous holiday, vacation and sick leave.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:
The Director of Managed Care and Network Operations is responsible for performing the following duties:
- Plan and direct the managed care program.
- Oversees the managed care plan operations, obligations & responsibilities inter-departmentally through the Clinicas System.
- Directs the department operations, activities, resources to meet budget and goals.
- Communicates and resolves issues.
- Initiate and lead the process of development, negotiation, implementation, monitoring and management of all managed care agreements.
- Conducts complex language and financial analysis with contracted providers and/or entities. Implements legal, financial & business requirements & objectives through negotiations.
- Develop, deploy and oversee contract strategy for hospitals, ancillaries, physicians and other professional services. Ensure services are in compliance with professional standards, local, state and federal regulatory requirements.
- Monitor health plans, providers, businesses and agencies to ensure that they efficiently and affectively provide needed services while staying with contractual agreements.
- Assist in developments of policies and procedures to adhere to the contractual agreements.
- Oversees the managed care plan, operations, obligations & responsibilities inter-departmentally throughout the Clinicas System. Directs department operations, activities, resources to meet budget and goals. Communicates and resolves issue.
- Develop and oversee the implementation of strategies to improve managed care performance in terms of utilization, patient access, cost, compliance with contractual quality measures, etc. Align improvement with quality and financial goals.
- Lead the identification, coordination and analysis of all financial, access and utilization data that results in clear business performance reporting and monitoring by payer and by lines of business. Works closely with Operations, Clinical Programs, Credentialing, Finance/Managed Care Analytics to do so.
- Perform other duties as assigned including participation in all safety programs which may include assignment to an emergency response team.
- Review financial statements, contract and fee reports, and other performance data to measure trends and goal achievement, determine areas needing cost reduction and program improvement.
- Partner with leadership from Clinical Programs, Operations and Quality to develop and implement change strategies in the healthcare delivery setting.
- Plans and monitors activities and staff including hiring, orienting, training, mentoring, continuing education, and evaluating, coaching & disciplinary actions of supervised staff members.
EDUCATION, EXPERIENCE AND QUALIFICATIONS
- Bachelor’s degree in business administration, public health, healthcare administration, or related field.
- Seven years of experience within the healthcare field, specifically within a management position in a Managed Care environment.
- Direct knowledge and experience with State and Federal laws and regulations pertinent to healthcare including HIPAA, Department of Managed Health Care (DMHC), Department of Health Care Services (DHCS), CMS, etc.
- Strong leadership and negotiation skills. Knowledge of managed care contracting rates for network providers, services, and facilities.
- Ability to operate well under high-stress conditions and be extremely organized, paying high attention to detail.
- Ability to read, analyze and interpret common industry related journals, financial reports and legal documents.
- Ability to respond to common inquiries or complaints from customers, regulatory agencies, or members of the business community.
- Ability to write reports and business correspondence and effectively present information to top management, clients, external groups and/or boards of directors.
- Ability to leverage interpersonal skills and technical knowledge to bring people and ideas together to perform effectively.
- Advanced ability to operate computers and related software for Microsoft programs including Word, Excel, Outlook and accounting software.
