Manager, Operations, IDR (On-site)

Posted Yesterday
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Schertz, TX, USA
In-Office
Junior
Healthtech • Insurance • Professional Services
The Role
Oversee daily Independent Dispute Resolution operations, manage workflow and staffing, collect and analyze production and QA data, implement continuous improvement, prepare performance metrics, provide vendor and client support, train staff, and collaborate with leadership to meet contractual obligations.
Summary Generated by Built In

Description

The Manager, Operations Independent Dispute Resolution (IDR) position is responsible for supporting the Director, Operations in daily operational workflow. This position plays a key role in overseeing day-to-day IDR operational workflows and ensuring the department functions efficiently and effectively.

This role will collaborate closely with leadership and staff to support departmental goals, strategies, programs, and projects for continuous improvement. The Manager, Operations also oversees the collection, aggregation, analysis, and reporting of complex production and quality assurance data used to support the efficient use of administrative resources and ongoing improvement initiatives.

Requirements

Essential Job Functions:

  • Collects, aggregates, analyzes, and reports complex production and quality assurance data.
  • Effectively oversees day-to-day operations, workload, and productivity in the operational workflow to ensure contractual obligations are met.
  • Ability to demonstrate effective communication, interpersonal, analytical, writing presentation, self-motivation, broad thinking, and business skills.
  • Competence in both oral and written English.
  • Provides excellent vendor support and effectively communicates and provides timely problem resolution.
  • Ability to establish and maintain effective and harmonious work relationships with team members and clients.
  • Prepares and analyzes department performance metrics as required.
  • Ability to multi-task and work proactively to meet time sensitive deadlines.
  • Strong organizational and task prioritization skills.
  • Ability to establish credibility and be decisive.
  • Knowledge and experience using continuous improvement methodologies and processes.
  • Ability to develop and update processes and procedures within the department.
  • Ability to maintain a professional manner and effectively collaborate with all levels of management.
  • Ability to solve problems in complex, multifaceted situations.
  • Ability to create and provide training to team members.
  • Evaluates staffing levels and submits recommendations to leadership to ensure staffing levels are adequate to support operational needs.
  • Collaborate with Director, Operations to ensure client requirements are met.
  • Communicates timely with leadership on urgent issues, objectives and needed areas of improvement.
  • Other duties as assigned.

Knowledge and Abilities:

  • Ability to solve problems in complex, multifaceted situations.
  • Ability to create and provide training to team members.
  • Extensive knowledge and experience in the Case workflow process.
  • Working experience and knowledge in Case Intake and Fulfillment process and procedures.
  • Proficient experience and/or knowledge of computer systems, data collection, and data dissemination.
  • Excellent verbal and written communication skills.
  • Management level customer service experience with clients.

Education and Experience:

  • High School Diploma or equivalent; Undergraduate degree preferred.
  • 1 year of case intake and fulfillment experience, to include workflow process and procedures is required.

Driving Essential: N/A

Position Demands:

This position requires sitting, bending, and stooping for up to 8 hours per day in an office setting. Ability to lift and move objects weighing up to 10 lbs. Ability to learn technical material. The person in this position occasionally needs to move about inside the office to access filing cabinets, office machinery, etc. Must be able to operate a computer and other office productivity machinery such as a calculator, copy machine, printer, etc. The person in this position frequently communicates with guests, team members, and vendors and must be able to exchange accurate information.

Equal Employment Opportunity:

The Company is a veteran-owned Company and provides Equal Employment Opportunities (EEO) to all Team Members and applicants for employment without regard to race, color, religion, sex, sexual orientation, gender (including gender identity), pregnancy, childbirth, or a medical condition related to pregnancy or childbirth, national origin, age, disability, genetic information, status as a covered veteran in accordance with applicable federal, state, and local laws, or any other characteristic or class protected by law and is committed to providing equal employment opportunities. The Company complies with applicable state and local laws governing non-discrimination in employment. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, promotion, discharge, pay, fringe benefits, membership, job training, classification, and other aspects of employment. Team Members who believe they are the victims of discrimination should immediately report the concern to their Supervisor and Human Resources Department. Discrimination and harassment will not be tolerated.

We are committed to creating an inclusive environment for all Team Members and applicants. We value the unique skills and experiences that veterans bring to our team and encourage veterans to apply.

Disclaimer

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of our personnel. All team members may be required to perform duties outside of their normal responsibilities from time to time, as needed.

Skills Required

  • High School Diploma or equivalent
  • Undergraduate degree
  • Minimum 1 year of case intake and fulfillment experience including workflow processes and procedures
  • Experience collecting, aggregating, analyzing, and reporting production and quality assurance data
  • Proficiency with computer systems, data collection, and data dissemination
  • Knowledge and experience using continuous improvement methodologies and processes
  • Ability to oversee day-to-day operations, workload, and productivity to meet contractual obligations
  • Strong verbal and written communication, interpersonal, analytical, and presentation skills
  • Management-level customer service experience with clients and vendor support/problem resolution
  • Ability to create and provide training and to evaluate and recommend staffing levels
  • Strong organizational, multitasking, task prioritization, and decision-making skills
  • Ability to sit, bend, stoop for up to 8 hours and lift/move up to 10 lbs; operate office equipment
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The Company
54 Employees

What We Do

ProPeer is an accredited, independent clinical review organization providing a comprehensive portfolio of solutions nationwide. It specializes in evidence-based clinical reviews, including utilization management, peer review, and dispute resolution for insurance carriers, health plans, and government entities, focusing on medical necessity, fraud, and medical litigation.

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