Healthcare Operations Manager

3 weeks ago

New York, New York, United States VillageCare Full time
Job Description

VillageCare is seeking a skilled Healthcare Operations Manager to oversee the coordination of Member Services staff, ensuring timely processing of requests and inquiries. This role requires strong problem-solving skills, excellent communication abilities, and a proven track record in healthcare operations management.

Key Responsibilities:

  • Oversight of Member Services staff scheduling, training, and day-to-day work flows
  • Communication with Director of Business Operations and AVP of Member Experience and Support Services
  • Assistance to members in accessing services, resolving issues, and communicating with the Interdisciplinary Care Team
  • Responsible for overseeing incoming calls, ensuring timely responses, and maintaining appropriate Member Service coverage on the Phone Queue
  • Ensuring all shifts are covered with adequate Representatives by language (Spanish, Cantonese, or Mandarin)
  • Overseeing fax processing to meet compliance standards
  • Facilitating meetings, coordinating agendas, reviewing new workflows, and maintaining planning foresight and work calendars
  • Assisting members in arranging appointments with physicians and other healthcare provider services
  • Facilitating communication between members, subcontractors, providers, and Care Managers
  • Providing plan information to new members, family members, or representatives
  • Responding to non-clinical complaints, logging member and subcontractor grievances, and resolving same-day complaints where possible

Requirements:

  • Bachelor's Degree in a relevant field
  • Minimum 5 years of job-related experience in healthcare HMO, Medicaid, and Medicare experience preferred
  • Strong ability to solve problems independently and interact with an integrated team
  • Excellent interpersonal, verbal, and written skills
  • Advanced Microsoft Office proficiency, including Outlook, Word, and Excel
  • Bilingual in Spanish, Russian, Creole, Chinese (Cantonese/Mandarin) preferred

Benefits:

  • Competitive compensation package
  • Paid Time Off (PTO), 10 Paid Holidays, Personal and Sick time
  • Medical, Dental, and Vision benefits
  • Health Reimbursement Arrangement (HRA) and Flexible Spending Account (FSA)
  • Education Reimbursement, Retirement Savings 403(b), Life & Disability Insurance
  • Commuter Benefits, Paid Family Leave, Additional Employee Discounts

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