1 day old

Director, Healthcare Payment Recovery Operations

Performant Financial
Sunrise, FL
  • Job Code
Performant Financial Corporation

Performant Corporation is an Equal Opportunity Employer (Minorities/Females/Disabled/Veterans).

Director, Healthcare Payment Recovery Operations
Job Code:2017-50-7-010
Location:Sunrise, FL
Status:Regular Full Time
The Director of Commercial Healthcare Payment Recovery Operations is a key member of the HCS organization with responsibility for building and operating the business unit focused on state and federal healthcare recovery programs. The role drives overall financial and operational performance for the Commercial Healthcare Payment Recovery business, and ensures client requirements and organization goals are met.
This includes direct oversight of multiple functions.   

- Develops and executes on operational strategies and plans, in accordance with internal objectives and relevant client contracts.
- Prepares, analyzes and utilizes reports to monitor operational health and adjust operational plans to optimize results.
- Applies in depth level of expertise in development of operational strategies including, but not limited to; staffing and resource management; policies and procedures and workflows; compliance, and quality.
- Proactively identifies opportunities for process improvement, efficiency, resolving problems, preparing and completing action plans. 
- Builds, manages and developments effectives teams, composed of managers, professionals and staff members that are both exempt and non-exempt.  
- Establishes accountability for performance monitoring (productivity/quality), communicates job expectations, trends, documentation, and ensures timelines are met. 
- Supports strategy by conducting needs assessments, capacity planning, cost/benefit analyses; preparing staffing models, establishing productivity and quality standards.
- Maintains professional and technical knowledge, including staying current with industry policy by tracking emerging trends in healthcare commercial billing recovery; attending educational workshops; reviewing professional publications; establishing personal networks; benchmarking state-of-the-art practices; participating in professional societies
- Develops effective relationships with leaders in the organization and has a strong understanding of the business. 
- Applies in-depth understanding of the inter-relationships of the business, functions, and support units throughout the organization.
- Accomplishes organization goals by accepting functional ownership; driving operational effectiveness and success, and; exploring value-add opportunities for continuous improvement.
- Builds HCS value and credibility internally and externally, and represents the organization in meetings with the client, provider organizations, contractors, subcontractors and vendors.
- Uses excellent communication skills in order to influence a wide range of internal and external audiences.
- Timely response to escalated inquiries from the client and providers.
- Support other departments in problem resolution as necessary.
- Inspires trust and credibility- delivers on commitments, HCS Commercial Repayment Operations subject matter expert
- Performs other incidental and related duties as assigned.

Required Skills and Knowledge:
- Demonstrated expertise (depth and breadth) of knowledge of State and Federal Healthcare programs, Medicare, Healthcare Billing, Secondary Payer, and Coordination of Benefits.
- Demonstrated ability to develop and execute operational strategies and plans.
- Strong project management and interpersonal skills, makes sound decisions, exhibiting initiative and intuitive thinking. Consulted often by others for advice and opinions and recognized as a leadership role model.
- Strong systems skills; easily adapts to effectively using new programs and applications and leverages technology in development and continuous improvement of operations and reporting.
- Must be a strong effective communicator, both orally and in writing, with an energetic and approachable style.
- Ability to establish and maintain effective work relationships internally and externally at all levels, and influence effectively.
- Proven experience in developing and managing high performing dynamic teams.
- Must excel in a fast-paced environment and demonstrate strong multi-tasking abilities.
- Good critical thinking, questioning, and listening skills; excellent attention to detail.
- Strong critical thinking, analytical and problem-solving skills.
- Time management skills for managing multiple tasks simultaneously, while completing work within allocated time frames.
Physical Requirements: 
Job is in a busy standard office environment with moderate noise level, sits at a desk and participates in meetings, uses office phone system; views a computer monitor, types on a keyboard and uses a mouse. Reads and comprehends information in electronic (computer) or paper form (written/printed). 
- Sit/stand 8 or more hours per day; has the option to stand as needed while on calls; reach as needed to use office equipment. 
- Consistently viewing a computer screen, typing, using a keyboard and mouse. 
- Uses phone; head-set can be provided. 
- Occasionally lift/carry/push/pull up to 10lbs. 
Education and Experience:
- Bachelor’s degree in Business, Accounting, Finance or related discipline (or equivalent combination of education and applicable experience).
- 10+ years relevant progressive operational management experience in healthcare insurance/billing and repayment involving medicare/medicare, coordination of benefits, secondary payer, and related.
- Experience evaluating and restructuring workflow and procedures, involving cross-functional activities and systems. 
- Experience reviewing contractual, regulatory, and procedural documents, and leveraging to develop and execute assessment tools, criteria and reporting.  
- Experience in role with similar scope of responsibilities, with proven track record 

Other Requirements:
- Must submit to and pass background check.
- Must not have any Federal or State liens resulting from County, State or Federal tax issues.
- Must not have any current defaulted student loans.
- Must be able to pass a criminal background checks; must not have any felony convictions or specific misdemeanors, nor on state/federal debarment lists.
- Must submit to and pass drug screen.
- Performant is a government contractor. Certain client assignments for this position may require additional background and/or clearances.

Job Profile is subject to change at any time.

Performant Financial Corporation is an Equal Opportunity Employer. Performant Financial Corporation is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law.



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Director, Healthcare Payment Recovery Operations

Performant Financial
Sunrise, FL

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Sunrise, FL

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