Regional Director, Operations
New
J
JobgetherHealthcare operations
Remote within the United StatesFull-TimeDirector
Salary129,700 - 162,100 USD per year
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Job Details
- Experience
- At least 5 years of professional experience in healthcare operations, including a minimum of 3 years leading multi-market Risk Adjustment or Quality programs.
- Required Skills
- Microsoft OfficeProcess improvement
Requirements
- Hold a bachelor's degree in Business Administration, Healthcare Management, Public Health, or a related field; an advanced degree is preferred.
- Have at least 5 years of professional experience in healthcare operations, including at least 3 years leading multi-market Risk Adjustment or Quality programs.
- Understand HEDIS quality measures, risk adjustment coding methodologies, claims, and electronic medical records (EMR).
- Have experience managing operational teams, vendor relationships, and complex healthcare programs across multiple locations.
- Demonstrate program and project management experience, including operational strategy and delivery of measurable results.
- Know process improvement methodologies and be able to conduct root cause analyses and implement sustainable improvements.
- Have experience with dashboards, KPIs, and performance reporting; SQL knowledge or ability to collaborate effectively with analytics teams is required.
- Have experience with workforce planning, staffing models, budget oversight, resource allocation, and operational performance management.
- Understand healthcare technology environments, including EMR systems, claims data, reporting tools, and technology-enabled workflows.
- Be proficient in Microsoft Office, particularly Word, Excel, Outlook, and PowerPoint.
- Be able to work independently in a remote environment and collaborate across geographically distributed teams.
- Be willing and able to travel approximately 4–10 days per month to partner locations.
- Six Sigma or Lean certification and experience with healthcare transformation or technology implementation are preferred.
Responsibilities
- Lead Risk Adjustment (BOI), Quality (HEDIS), and Cost of Care programs across at least three markets.
- Develop and maintain SOPs, SLAs, and RACI frameworks for program delivery.
- Optimize medical record reviews, coding reviews, chart collection, query workflows, and provider engagement.
- Monitor market performance, identify operational challenges, and implement corrective actions.
- Define and monitor KPIs, conduct root cause analyses, and lead continuous improvement initiatives.
- Coordinate cross-functional teams to resolve escalated operational challenges and prepare for new initiatives.
- Oversee program budgets, staffing, contractor, and vendor expenditures, and resource utilization.
- Partner with Data & Analytics and IT/Engineering on technical requirements, data pipelines, EMR and claims integrations, and reporting dashboards.
- Evaluate, test, and implement automation solutions with technology teams.
- Lead regional capacity planning, workforce modeling, recruitment, onboarding, training, and performance management.
- Build relationships with healthcare providers, vendor partners, and internal stakeholders.
- Travel approximately 4–10 days per month to partner medical groups and regional operations.
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