Director of Group Health

This is a fully remote position, open to applicants in United States.

📋 Description

• **JOB SUMMARY**

• The Director of Group Health is accountable for ensuring overall client satisfaction and fostering growth within Dane Street’s Group Health Division.

• The success of Dane Street is dependent on both individual and team contributions on a daily basis. We prioritize the care of our customers, our colleagues, and Dane Street itself. It is our collective responsibility to cultivate a positive work environment that enhances client satisfaction and delivers results.

• **MAJOR DUTIES & RESPONSIBILITIES**

• - Ensure the achievement of essential client metrics such as Turnaround Time (TAT), Quality (assessed through clarification percentage), P2P success, overturn rate, and any additional key performance indicators established by our Group Health clients.

• - Lead the Operations Management Team and supervise all activities directly linked to operational procedures.

• - Attract, recruit, and retain team members.

• - Collaborate with the Group Health Operations Teams on both internal and external quality audits, providing recommendations for process improvements and updates.

• - Suggest development initiatives aimed at enhancing technology usage for improved client satisfaction and internal efficiencies.

• - Oversee the reconciliation of client outcomes reports and issue logs.

• - Manage the overall Profit and Loss of the Group Health Division.

• - Partner with the National Medical Director in the development and management of the physician panel.

• Additional duties and special projects as assigned based on business requirements.

⛳️ Requirements

• **EDUCATION/CREDENTIALS:**

• A Bachelor’s or Graduate’s Degree is preferred.

• **JOB RELEVANT EXPERIENCE:**

• At least 5-10 years of experience managing a team of Utilization Management (UM) Nurses within a Health plan or IRO.

• RN (preferably with a BSN or higher).

• Familiarity with Utilization Management standards and guidelines.

• Proven experience leading an operational unit or division, meeting customer service objectives, and achieving profitability goals and objectives.

• **JOB RELATED SKILLS/COMPETENCIES:**

• Exhibit outstanding communication skills with a comprehensive understanding of the company’s business lines. Ability to apply critical thinking, manage time effectively, and meet specific deadlines. Proficiency in computer skills and typing is essential.

• **WORKING CONDITIONS/PHYSICAL DEMANDS:**

• Any lifting, bending, traveling, etc. required to perform the job duties outlined above. Extended periods of sitting and computer work are expected.

• **WORK FROM HOME TECHNICAL REQUIREMENTS:**

• Must provide and maintain their own internet services.

• An uninterrupted internet connection is required for all work-from-home positions.

• This job description may be subject to change at any time.

🏝️ Benefits

• Join our team at Dane Street and take advantage of a comprehensive benefits package aimed at supporting your well-being and peace of mind. We provide a variety of benefits that include medical, dental, and vision coverage for you and your family. Additionally, there are voluntary life insurance options available for you, your spouse, and your children. Other voluntary benefits include hospital indemnity, critical illness, accident indemnity, and pet insurance plans. Employees are provided with basic life insurance, short-term disability, and long-term disability coverage at no cost. Our generous paid time off policy allows you time to relax and recharge, while our 401k plan with company matching supports your financial future. Apple equipment and a media stipend are provided for your remote workspace.

• ABOUT DANE STREET:

• A dynamic, Inc. 500 Company with a high-performance culture, is in search of insightful, forward-thinking professionals. We process over 200,000 insurance claims annually for leading national and regional Workers’ Compensation, Disability, Auto, and Group Health Carriers, Third-Party Administrators, Managed Care Organizations, Employers, and Pharmacy Benefit Managers. We offer tailored Independent Medical Exams and Peer Review programs to assist our clients in achieving appropriate medical determinations as part of the claims management process.