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Friday Health Plans Director of Provider Operations in Alamosa, Colorado

Who You Are

You are an individual with excellent capability of ensuring overall completion of our provider network after contract. You understand the importance of credentialing, data load, maintaining of directories and management of the provider manual within timely manner. While establishing Provider Operations policies and procedures, managing staff as they support provider inquiries and load contracts comes as a second nature to you. If this sounds like you, you're the Director of Provider Operations we've been looking for and we'd like to meet you.

Who We Are

Friday Health Plans isn?t your average health insurance company. We?re not about unnecessary extras and confusing terminology. We cover the basic health services you?ll likely use the most at a price that just might make your wallet happy. Our simple health plans and friendly service keep you covered so you?re free to live every day like it?s Friday.

As a Denver-based startup company, we?re looking for smart, talented people like you to join us. We value collaboration, innovation, passion, and calculated risk-taking. Now in year four and growing rapidly, we?re looking for people who lead by example, and that example is one of flexibility, reliability, and positivity. If this sounds like you, then we want you on our team.

What You?ll Do:

  • Assisting the manager in supervising Provider Operations Department personnel, including ongoing training, conflict resolution and annual evaluations

  • Evaluating and recognizing any staffing needs and working with the Senior Director of Operations and Provider Ops Manager on conducting interviews

  • Attends all required meetings

  • Meets with the Provider Operations Department on a regular bases to update on projects with any new information throughout the organization

  • Takes escalated calls transferred from staff and facilitates a resolution

  • Track contracts through the Provider Operations workflow to ensure the complete process has been met

  • Tract and report credentialing stats and submit to the Senior Director of Operations and COO for review

  • Provide department metrics as directed for submission to the Quality Assurance Committee

  • Develop call scripting for Provider Operations, as this may be required

  • Identify trends, and design and implement programs to improve workflows

  • Ensure compliance with all relevant federal and state statures, regulations, rules and guidelines

  • Ensure the department is meeting URAC requirements

Required Knowledge, Skills & Abilities:

  • Supervisory skills

  • Management ability

  • Detail oriented

  • Highly organized

  • Ability to prioritize and make routine decisions

  • Works well under pressure

  • Professionalism and ability to use diplomacy in working relationships

  • Excellent phone skills

  • Ability to communicate effectively verbally and in writing at all levels from clerical to senior management

  • Ability to work on multiple projects simultaneously

  • Exhibits objectivity and openness to others? views

Required Education/Experience:

  • Associate or Bachelor Degree in Business Administration preferred but not required.

  • Minimum of 5-7 years of experience managing staff.