GENERAL SUMMARY OF POSITION: 

Under the general direction of the Associate Director, the Operations Supervisor provides supervisory and management support to program operations on prior authorization and care management activities.  This position is responsible for managing the day-to-day operations of administrative, reporting, and information systems/technology functions as related to contracted deliverables.

MAJOR RESPONSIBILITIES:

• Manages program support staff to effectively accomplish departmental goals and objectives;
• Oversees day-to-day operations tasks, including but not limited to resource allocation, work volume distribution, and project management.
• Monitors work volume to ensure staffing levels are adequate and appropriate efficiencies are maintained.
• Provides direct supervision to operations staff, including leading all recruitment, hiring, performance management, and termination of team members.
• Supervises operations staff to ensure projects and other deliverables are achieved in a timely and high quality manner, in collaboration with other departmental staff and resources.
• Ensures timely and high quality orientation and training of new team members and training of existing team members on new procedures.
• Oversees administrative staff's interface with information systems/technology functions including both internally and externally owned databases.
• Works closely with Associate Director to promote adherence to sound operational practice.
• Participates in performance improvement initiatives and demonstrates the use of quality improvement initiatives within the Program.
• Lead small projects or subcomponents of larger, more complex projects.
• Participates in program development project teams.
• Oversees incoming communication including central telephone and email processes.
• Works with the Leadership Team to establish efficient office procedures and policies.
• Compile and analyze data, produce project reports, maintain project plans and schedule meetings.
• Facilitates a positive working relationship between administrative and clinical staff and state agencies, as appropriate.
• Provides input on new policies and procedures, services and programs and assists with their implementation.
• Interfaces with Human Resources Department on personnel related issues as needed.
• Provides coordination with and serves as liaison to other components of UMMS as required.
• Maintains the confidentiality of all business documents and correspondence.
• Attends and participates in meetings as required.
• Comply with established departmental policies procedures and objectives.
• Comply with all health and safety regulations and requirements.
• Performs other similar and related duties as required or as directed.

ADDITIONAL RESPONSIBILITIES:

Collaborates with centralized departmental administrative and finance staff to ensure all personnel action activity related to hiring, firing, performance measurement, contracting, and funding are completed accurately and in a timely manner.

REQUIRED QUALIFICATIONS:

• Bachelor’s degree or equivalent experience required.
• 4-6 years of related experience.
• 1-2 years supervisory or leadership experience.
• Strong inter-personal and/or supervisory skills.
• Strong oral and written presentation skills.
• Strong analytic skills and proven competence in independent problem solving.
• Superior computer skills including strong knowledge of spreadsheet software and/or other system applications.
• Exercises professional behavior and discretion.
• Ability to assess priorities and operate in a flexible manner in order to meet the dynamic needs of the department.

Working knowledge of MMIS

Health Care Finance Solutions is a part of Commonwealth Medicine (CWM), the health care consulting division of UMass Medical School, Massachusetts’ only public medical school. As nationwide leaders in the development and implementation of health care reform, CWM and HCFS stay ahead of health care trends and help strategize and plan for changes that impact both health care delivery systems and patients on the local, state and national level.

HCFS helps state agencies identify opportunities to increase savings and reimbursements through federal and other third party sources, establish effective savings and reimbursement programs, and capitalize on all possible revenue streams. At the same time, HCFS identifies opportunities for our clients to increase health care related services, reduce the net cost of delivery, and help ensure individuals receive the health and human service benefits to which they may be entitled.

The Public Health Initiatives unit at HCFS extends these services to state and local public health authorities to enhance their ability to sustain essential health care services to communities by identifying payers for these services and coordinating with other payers to seek reimbursement for these services. PHI provides its clients with comprehensive medical billing and accounts receivable mechanism, as well as other services, to maximize the collection of federal, third-party, and private reimbursement for health care and related services provided by state and local public health authorities.  The program produces over $8 million in gross charges to liable payers and generates over $3.5 million in net revenue. 

Under the supervision of the Assistant Director for the PHI unit, the Operations Supervisor and be responsible for the review and submission of claims within timely filing limits as well as ensuring any system updates related to program services are evaluated annually and updated as appropriate.  

#LI-BG1