Network Management Operations Director

The Job

Directs the operations for Network and cross-functional areas of the organization that touch providers.

The Network Management Operations Director supports SCAN’s National Markets and the Network Management Department in developing processes, designing workflows, driving implementations, and supporting ongoing operations that impact SCAN’s providers and the teams engaging with providers.

This position facilitates progress on key initiatives by building strong partnerships across the organization and managing effective communications.

The Network Management Operations Director anticipates business needs and demands, and works to provide logical, innovative, and creative solutions.

Position does not supervise anyone currently but may in the future.

You Will

• Work with key leaders throughout the company to develop network management structure, processes, and systems that enable operational scalability, organizational growth and optimal performance outcomes.
• Drive and manage implementations and ongoing operations of network management strategies. Including but not limited to : Developing intra- and inter-department cross-functional processes and improvements.

Designing and documenting workflows. Creating templates, presentations and communications needed to enable operational efficiencies,

Driving execution of new processes to team members and relevant departments. Partnering with Network Administration team to enable training of team members and stakeholders on new processes and systems.

Identifying any areas of inefficiencies that impact a provider (eg credentialing, directory display, onboarding, claims, authorizations, reporting, communications), identifying solutions and partnering with relevant stakeholders for improvements.

• Utilizing technologies and data algorithms to enable operational efficiencies. Lead business subject matter expert and / or project management of new network vendor implementations and tools such as CRM, Support implementation of regulatory compliance requirements impacting Network Management Operations.
• Key leader in supporting large cross-functional programs and being the established business owner to streamline and prioritize based on network needs.

Creating reporting to track progress on strategic initiatives. Coordinating and owning relationships with internal and external partners to ensure SCAN operates at a level of excellence to be viewed as a provider’s Medicare Advantage payer of choice.

Prepare detailed implementation plans inclusive of success metrics and criteria for deciding whether to replicate a strategy.

Develop and maintain scalable playbooks for repeatable strategies. Assess key aspects of the company’s operations regarding progress towards quarterly and yearly objectives.

Facilitate progress towards key objectives and assist in diagnosing and solving tactical problems that limit goal achievement.

Prepare and review analytics to provide visibility to network operational strategies. Provide insightful, data-driven recommendations to optimize decision making.

Monitor external communications and information resources for emerging trends and industry developments that inform adjustments to current network operational strategies.

Creates policies for implementing and integrating firewalls, web servers, backup systems, and cloud technologies. Ensures an effective utilization of LAN / WAN / wireless / VoIP operations.

Performs regular analysis to evaluate network effectiveness, and implements corrective action as needed. Liaisons with other functional leaders to ensure business requirements are being met through network architecture.

Oversees all facets of network operations relating to architecture, engineering, storage, security, development, and maintenance.

Establishes overarching protocol for the design, installation, configuration, and optimization of network architecture.

• Forecasts and completes capacity planning to avoid network downtime and provide for stability and reliability. Communicates regularly with vendors, to assess changes or adaptations to network hardware or software.
• Contributes to strategic planning, direction, and goal setting for the department or function in collaboration with senior management.

Establishes departmental policies, practices, and procedures that have a significant impact on the organization.

All other duties as assigned.

Your Qualifications

• 5-7 years of related experience relevant to SCAN’s products, programs, services and / or business operations.
• 5 years of leadership experience.
• Experience in the Health Care industry is strongly preferred.
• Excellent project management skills with experience in expediting large, complex and / or long-term projects.
• Excellent problem-solving skills with the ability to find creative solutions for issues where the answers are not clear.
• Ability to collect large magnitude of business subject matter knowledge and connect dots across the organization.
• Strong analytical skills with the ability to use statistical tools and interpret and apply the results.
• Highly developed quantitative, oral, written and interpersonal communications skills with the ability to effectively convey information in a clear and concise manner.
• Strong platform and presentation skills. Proactive and independent thinker. Strong multi-tasking and organizational skills with minimal supervision.

Team-player, innovative, problem solver, detail oriented. Ability to execute work under pressure and tight deadlines.

• Planning skills. Technical expertise. Debugging skills. Problem-solving skills. Design expertise.
• Decision-making skills.
• Ability to drive strategic direction.
• Leadership skills.

What's in it for you?

• Base Pay Range : $125, - $200,
• Work Mode : Mostly Remote
• An annual employee bonus program
• Robust Wellness Program
• Generous paid-time-off (PTO)
• 11 paid holidays per year, plus 1 additional floating holiday
• Excellent 401(k) Retirement Saving Plan with employer match
• Robust employee recognition program
• Tuition reimbursement
• An opportunity to become part of a team that makes a difference to our members and our community every day!
11 hours ago