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Job Description

Vice President of Customer Operations

Job Description

Reporting to the Chief Financial Officer, the Vice President of Customer Operations provides leadership and direction for operating units at BMCHP including the Customer Care Center and Enrollment. Under the direction of the CFO, the VP of Operations is responsible for articulating and implementing the vision and strategy for the external customer-facing areas of the Operations division that enables BMCHP to achieve its business strategies and goals.

Key Functions/Responsibilities:

  • Ensures departmental compliance with contractual, regulatory, NCQA, and corporate requirements, guidelines, and goals including turnaround times and reporting.
  • Tracks trends, makes decisions based on organized information, and supports decisions with articulate written and verbal communications.
  • Creates annual budget and is responsible for the budget oversight of department. Provides business justification for capital and resource needs.
  • Utilizes Key Performance Indicators to prioritize improvements efforts.
  • Establishes operating processes that embrace team-based continuous improvement methodologies to achieve sustainable business results.
  • Coaches leaders to demonstrate the behaviors required to implement sustainable best practice processes.
  • Actively participates in business reviews and partner with leadership to develop the systems and tools required to achieve operational excellence.
  • Prepares operations reports for submission to the CFO and his/her peers.
  • Develops and executes strategic growth initiatives and plans within assigned facilities and associated markets in partnership with the leadership team.
  • Develops strategic and operational plans with defined performance standards, metrics and action plans that can be tracked against timelines to evaluate organizational performance
  • Develops organizational capability to support growth through effective employee development, succession planning and the effective use of project management methodologies.
  • Consistently administers human resources policies and procedures.
  • Serves as corporate steward for BMCHP’s member and provider portals.
  • Leads stakeholder team responsible for recommending corporate use of available functionality including modifications to the application.
  • Supports projects necessary to implement workflow changes which move manual work to the system.

Supervision Exercised:

  • Directly manages and indirectly manages a total staff of 125-150.

Supervision Received:

  • Receives general direction weekly or as needed.

Qualifications:

Education:

  • Bachelor’s degree required

Preferred/Desirable:

  • Master’s degree in related field strongly preferred

Experience:

  • Must have at least 10 years of experience in Customer Operations
  • 5+ years of management experience in a health care setting

Preferred/Desirable:

  • Prefer Medicaid experience

Certification or Conditions of Employment:

  • Pre-employment background check

Competencies, Skills, and Attributes:

  • Able to build strong teams with complementary skills, and to lead, motivate, and inspire teams.
  • Able to develop creative strategies and to tap the potential of individuals and groups.
  • Able to continually assess needs and implement measures that will ensure customer expectations are met or exceeded.
  • Able to turn problems into opportunities for change.
  • In-depth knowledge of Operations in a managed care environment. Knowledge of peripherals such as prior authorizations, benefits and provider records.
  • Strong writing skills that exhibit concise, descriptive, and professional prose. Confident presentation skills.
  • Able to diplomatically and professionally interact with stakeholders concerning routine and escalated matters. Ability to communicate effectively at all levels of the organization.
  • Knowledge of types of health care providers and their operations.

Working Conditions and Physical Effort:

  • Work is performed in an office setting with no or very limited exposure to physical risk
  • Regular and reliable attendance is an essential function of the position.

*Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status.