Director, Operations

The Director, Operations has overall responsibility for the business operations of a growing portfolio of nationwide industry utilities aimed at streamlining business processes across the healthcare system. The role manages a team that directs and oversees vendor-operated service centers located in three countries. These service centers provide call center, document processing, data entry, fulfillment and other production support functions to providers, health plans and other users of CAQH services. This role is a full-time, exempt , remote position and reports to the Vice President, Operations.

PRIMARY RESPONSIBILITIES:

• Lead planning for the Solutions-wide operations function and evolve it into a data-driven, proactive service organization that advances CAQH goals.
• Develop an overarching long-term vision for the operations function that improves quality and efficiency and define a roadmap for implementation of identified capabilities.
• Partner with CAQH product managers and other members of the Solutions team to identify, define and prioritize operational requirements for current and new offerings, participate in product development activities, and support change management procedures.
• Oversee the implementation of new capabilities identified on the operations strategic roadmap to support product and organizational goals.
• Direct the review of operations systems and procedures, and recommend improvements to increase throughput and efficiency, drive down costs and improve quality.
• Implement necessary training, dashboards/reports and other tools required to execute the operations strategic vision.
• Lead the development and implementation of policies and procedures and other documents to mature operations function.
• Manage relationships with external service providers to ensure successful initial and ongoing delivery of new operations capabilities.
• Manage a team of internal and external operations resources to meet and exceed service level expectations.
• Develop and maintain forecasts of demand and capacity for operations functions.
• Budget owner with responsibility for managing full operations budget across all Solutions.
• Actively monitor and manage internal and external operations centers to meet service level expectations.
• Serve as an escalation point for operations issues, manage escalated problem resolutions and quarterback subsequent root cause analysis and resolution.
• Systematically, identify, prioritize and execute improvement opportunities. Collaborate with product management, technology, program management and other departments to coordinate cross functional work and opportunities as applicable.
• Oversee the preparation for, and successful completion of, periodic accreditation reviews (e.g., NCQA) and compliance requirements (e.g. HIPAA).
• Manage vendor and in-house staff, provide oversight and execution of plans and budgets, manage and improve business processes, and monitor and report operational results.
• Provide strategic visioning and leadership for the operations function and serve as a key contributor within the Solutions management team.
• Promote leading healthcare industry and organizational thinking, cultivate new ideas, foster innovation, provide subject matter expertise across settings, and mentor/coach staff members. Frame complex trends into logical, implementable services/products.
• Lead the delivery of sound service and model excellent relationship management with external consultants, vendors and customers.

SUPERVISORY RESPONSIBILITIES:

Position directs and supervises both internal (CAQH) and external vendor staff. Responsible for designing and growing a successful support team through team member mentoring with a focus on career growth and succession planning.

KNOWLEDGE, SKILLS AND ABILITIES:

• Strong focus on customer service excellence and a positive user experience.
• Highly organized and efficient, with excellent follow-up skills.
• Strong and persuasive communication skills (written and verbal).
• Strong team building and personnel management capabilities.
• Ability to translate vision and goals into day-to-day activities and behaviors.
• Excellent abilities to direct and manage existing business processes while continuously looking for process improvement opportunities.
• Able to focus on details while still articulating the "big picture".
• Ability to transform details and facts into recommendations and action plans.
• Ability to produce policy and process documentation.
• Ability to look at situations from several points of view.
• Analytical mindset with ability to creatively solve problems.
• Excels at operating in a fast pace and changing environment.
• Displays consistent professionalism and good judgment.
• Microsoft Office applications proficiency required and SalesForce experience a plus.
• Proficiency in the MS Office Suite (e.g., Word, Excel, Office 365 and PowerPoint)

EXPERIENCE:

• Minimum of 5 years of experience in a healthcare setting, with emphasis on efficiency, implementation of new capabilities and overall customer satisfaction.
• Minimum of 10 years managing business operations and customer-facing support with a technology focus.
• Minimum of 5 years supervising operations management, staff, and vendors.
• Experience with designing, implementing and managing both in-house and outsourced solutions strongly preferred.

EDUCATION:

Bachelor's Degree Preferred (business, healthcare administration or technology preferred).

WHO WE ARE

Named one of the "Best Places to Work" by Modern Healthcare for five consecutive years, CAQH has helped nearly 1,000 health plans, 1.6 million providers, government entities and vendors connect, exchange information and operate more efficiently. CAQH technology-enabled solutions and its Committee on Operating Rules for Information Exchange (CORE) bring the healthcare industry together to make sharing business information more automated, predictable, and consistent. CAQH Explorations researches opportunities to reduce the burden of manual processes in healthcare administration.

WHAT YOU GET

CAQH recognizes that its most important asset is its growing team of smart, creative, collaborative, forward-thinking and passionate professionals - and that a comprehensive employee benefits package is an important factor for them in choosing where to work. CAQH offers competitive compensation along with an extensive benefits package for all full-time employees, including medical, dental and vision coverage, tuition assistance and a 401k. We offer full-time remote work to all staff from any location and maintain a physical office (with many amenities) in downtown Washington, DC.

CAQH is an equal opportunity employer. It is our policy to recruit, hire, train, and promote individuals, as well as administer any and all personnel actions, without regard to race, color, religion, sex, national origin or ancestry, age, marital status, disability, protected veteran status, personal appearance, sexual orientation, gender identity or expression, familial status, family responsibilities, matriculation, political affiliation, genetic information, source of income, place of residence, or any other characteristic protected by law. CAQH will not tolerate any unlawful discrimination and any such conduct is strictly prohibited.

This position requires proof of full vaccination against COVID-19 prior to the first date of employment, subject to applicable law. If you are offered employment, this requirement must be met by your date of hire, unless a reasonable accommodation request is received and approved.

Applicants have rights under the Family Medical Leave Act (FMLA), Equal Employment Opportunity (EEO), and the Employee Polygraph Protection Act (EPPA). If you are interested in applying for employment with CAQH and need an accommodation to apply for a posted position, contact CAQH Human Resources at 202-517-0436.

#LI-Remote