Director, Operations (Provider Engineering)

Overview:  The Director of Operations for Provider Engineering will be responsible for Application Operations Support (AOS) and Payer Compliance (Claims Rules) teams.  The Director will manage the activities of support engineers, rules engineers, developers, project managers and supervisors with direct reporting to the SVP of engineering to achieve divisional goals and objectives.  The Director will also identify and drive initiatives to improve operational efficiency using software automation. 

Duties and Responsibilities: 

• Develop and implement strategy for Application Operations Support (AOS) and Payer Compliance (Claims Rules) teams;  

• Drive organization towards metrics and revenue goals, with the objective to exceed business expectations; 

• Manage compliance with client policies, procedures and client contractual requirements;  

• Evaluate, align processes and procedures, as appropriate; Design and implement process improvements consistent with the direction of the teams;  

• Demonstrated ability to develop and implement process enhancements including technology and performance;  

• Develop and maintain “expert-level” knowledge of various methodologies, regulations, processes, timelines, and general clinical approach underlying the Company’s current and potential product lines;  

• Assist in relationship building with clients through remote and onsite meetings and presentations. Oversee the assembly of financial and outcomes results for client presentations; 

• Perform ad-hoc analyses, provide decision support and ensure information flow and status updates to and from the senior leadership; 

• Maintain compliance with Inovalon’s policies, procedures and mission statement; 

• Adhere to all confidentiality and HIPAA requirements as outlined within Inovalon’s Operating Policies and Procedures in all ways and at all times with respect to any aspect of the data handled or services rendered in the undertaking of the position; 

• Fulfill those responsibilities and/or duties that may be reasonably provided by Inovalon for the purpose of achieving operational and financial success of the Company; and 

• We reserve the right to change this job description from time to time as business needs dictate and will provide notice of such. 

Job Requirements: 

• 8-10+ years of experience in the management of employees and in supporting medical providers;  

• Develop support service levels, deliverables, and reportable key service metrics results; 

• Design and develop vendor management connections, integrations, and provider support model; 

• Monitors progress and making constant adjustments, and decision based on company objectives; 

• Ability to multi-task and meet tight deadlines; 

• Ability to coach and motivate managers and others, with high influencing skills;   

• Experience in the management of teams with diverse skill sets (e.g. technical, clinical, operations, etc.) and the execution of large-scale product offerings supporting an expanding client base;  

• Superb problem-solving skills and strong interpersonal skills to effectively convey management needs to colleagues and functions throughout the company;  

• Proven verbal and written communication skills including the ability to present to both internal and external client senior management; and  

 
Education: 

• Bachelor’s degree or equivalent experience; and 

• Master’s degree in business or a healthcare-related field preferred. 

Physical Demands and Work Environment: 

• Sedentary work (i.e. sitting for long periods of time) Exerting up to 10 pounds of force occasionally and/or negligible amount of force; 

• Frequently or constantly to lift, carry push, pull or otherwise move objects and repetitive motions; 

• Subject to inside environmental conditions; and 

• Travel for this position will include less than 5% locally usually for training purposes.