Universal American is a New York Stock Exchange company with annual revenues of more than $2 billion. Through our family of healthcare companies, we provide health benefits to people covered by Medicare and/or Medicaid. We are dedicated to working collaboratively with healthcare professionals in order to improve the health and well-being of those we serve and reduce healthcare costs.
Well-capitalized and highly entrepreneurial, Universal American has been on the cutting edge of healthcare for more than 21 years. We offer Medicare Advantage plans to people with Medicare. We partner with providers in Accountable Care Organizations that serve people with Original Medicare. And we provide array of healthcare services to states, municipalities, health plans and other entities in the world of Medicaid. In everything we do, we focus on improving the coordination of healthcare through collaboration between payers, providers and patients to achieve the best health outcomes possible.
For more information on Universal American, please visit our website at www.UniversalAmerican.com.
The Manager of Operations will provide direct support to the Executive Director by (1) implementing UA vision and strategy, (2) deploying organizational continuous improvement and employee development, (3) eliminating barriers by enabling effective communication with operations and sales/ marketing strategy with deployment, and (4) being the subject matter expert on values, philosophies and tools. The Manager will effectively mentor at all levels of the organization while developing employees within area of expertise.
• Track and analyze key UA metrics to identify opportunities for improvement projects and work with Operational teams to drive successful design and implementation of solutions.
• Provides Medical Management, Revenue Management, HEDIS/ STARS, Provider Relations and Network Development program oversight and reporting on all projects and initiatives.
• Interact with senior management to generate buy-in across functional areas and facilitate sessions for project selection and project activities that align with the overall organizations improvement roadmap.
• If necessary, facilitates teams to develop, implement and sustain improvements in processes and outcome metrics.
• Provide leadership and direction staff for strategy for breakthrough levels of improvement in customer satisfaction, process capability and quality.
• Work with team management and other operating leaders to develop project deployment STARS strategy, goals and priorities.
• Manage and mentor managers to enhance understanding of continuous improvement methodology and application related to STARS/ HEDIS education and improvement.
• Work cross-functionally to develop optimal solutions across the business and serve as the subject matter expert on continuous improvement.
• Manage/Facilitate process improvement related to Network Operations and execution of Quality Improvement plans.
• Complies with all guidelines established by the Centers for Medicare and Medicaid (CMS) and guidelines set forth by other regulatory agencies, where applicable, and defined in the Universal American Corporate and department policies.
• And all other duties assigned by the Director, manager and/or supervisor.
• Professional verbal and written communication skills, with the ability to clearly articulate thoughts and ideas.
• Organizational skills with the ability to handle multiple tasks and/or projects at one time.
• Customer service skills with the ability to interact professionally and effectively with providers, physicians, and staff from all departments within and outside the Company.
• Analytical and interpretation skills including departmental, utilization, financial and operations data.
• Decision-making skills with the ability to investigate and weigh alternatives and select the course of action that provides the greatest benefit to the organization.
• Creative thinking skills with the ability to ask the needed bigger-picture questions that lead to process and team improvements.
• Time management skills with the ability to prioritize and schedule daily activities for the most efficient use of time.
• Problem solving skills with the ability to look for root causes and implementable, workable solutions with the ability to implement change management.
• Interpersonal skills with the ability to work in a fast-paced environment and participate as an independent contributor with little supervision or as an active team member depending on the situation and needs.
• Leadership skills with the ability to empower, engage, motivate, evaluate and manage team members individually and as a group.
• Must have a track record of producing work that is highly accurate, demonstrates attention to detail, and reflects well on the organization.
• Bachelor’s degree
• Utilization Review and Medical Management Experience
• Network Development and Operations Experience
• Change Management training/certification preferred
• Personal computer experience should include working with Microsoft Word, Excel, PowerPoint and Outlook at the intermediate level at a minimum, as well as Visio, SharePoint.
Universal American Corp. is an Equal Opportunity / Affirmative Action Employer and does not discriminate because of age, color, disability, ethnicity, marital or family status, national origin, race, religion, sex, sexual orientation, military veteran status, or any other characteristic protected by law. We are committed to attracting, retaining and maximizing the performance of a diverse and inclusive workforce.