Group Health Operations Manager (RN/LPN)

A fast-paced, Inc. 500 Company with a high-performance culture, is seeking insightful forward-thinking professionals. We process over 200,000 insurance claims annually for leading national and regional Workers’ Compensation, Disability, Auto, and Group Health Carriers, Third-Party Administrators, Managed Care Organizations, Employers, and Pharmacy Benefit Managers. We provide customized Independent Medical Exams and Peer Review programs that assist our clients in reaching the appropriate medical determination as part of the claims management process.

100% REMOTE JOB SUMMARY Oversee and ensure the overall profitability of the regional operations center. This includes but is not limited to reaching and exceeding financial & referral goals, properly managing staffing efficiencies throughout the team, managing performance expectations & improvements for existing staff. Present management with regular reporting on any topic requested by the management team. Dane Street’s success relies on individual and team contributions every day. We care for our customers, each other and Dane Street. It is the responsibility for all of us to maintain a positive working environment that promotes client satisfaction and results.

Driving Revenue Growth: The Operations Manager drives revenue growth by delivering excellent Customer service. This includes meeting scheduling best practices and turnaround time requirements. Ensuring the timely delivery of high quality reports. Managing client inquiries in a timely manner. Optimizing Physician cost Ensuring that client invoices adhere to the agreed upon fee schedule. Overseeing the proper selection of physicians. Specifically ensuring that the team selects the most appropriate physician based on the claimant’s location, the required specialty, and the most appropriately priced physician based on the client’s fee schedule. Building relationships with key physicians to ensure panel retention. Manage Staff Performance and capacity: Monitor key performance metrics of individual Customer Service Representatives (CSR) and Quality Assurance (QA) Specialists. Ensure the team meets or exceeds 85% of output goals for scheduling and Quality Assurance targets. Responsible for hiring new staff members based on increased referral volume and/or the addition of new clients. Conducts performance evaluations that are timely and constructive. Handles discipline and termination of employees as needed and in accordance with company policy. Responsible for the overall production, performance, and quality of the assigned region. Plans and organizes daily activities related to production and operations. Measures productivity by analyzing performance data, financial data, and activity reports. Coordinates with other support departments such as human resources, finance, and IT and BA to ensure successful production operations. Determines labor needs to meet production goals.