Director, Operations

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

📋 Description

• Collaborate closely with the VP of Operations to strategically position the organization and its subsidiaries for continuous organizational transformation.

• Oversee the daily administrative workflows for Nexus Enterprises, LLC and ProPeer Resources, LLC.

• Supervise daily operations and manage the operational management team.

• Ensure staff performance across the Utilization Review and Independent Review Organization business lines.

• Propel clinical, financial, and utilization targets through effective management and role modeling.

• Administer financial, human resources, leadership, quality, and operational objectives.

• Engage in program development and initiatives for unit performance enhancement.

• Assess performance against operational plans and standards, providing comprehensive reports.

• Deliver monthly and ad hoc performance reports.

• Formulate objectives, plans, processes, programs, budgets, and financial forecasts for Operations.

• Facilitate coordination and collaboration with other departments and management.

• Evaluate operational projects that involve significant organizational changes.

• Strategize new technological advancements that support operational functions and the organization's mission.

• Set objectives and processes for assigned activities and review the Operations Management Team's goals.

• Recruit, retain, train, and develop qualified personnel.

• Oversee human resources utilization, staff satisfaction, development, and progressive discipline.

• Ensure workflows meet client-specified requirements accurately.

• Participate in implementing quality improvement and regulatory standards.

• Investigate interdepartmental issues and implement corrective actions.

• Establish, assess, and monitor Utilization Review processes, policies, and procedures.

• Support company and departmental QA/QI initiatives.

• Maintain effective communication with team members, departments, management, and external entities.

• Ensure compliance and suggest improvements to policies and procedures.

• Review, modify, and submit budget proposals.

• Provide orientation and on-the-job training for new personnel.

• Clearly define and communicate the direct-report duties, responsibilities, authority, and accountability.

• Perform additional duties and responsibilities as assigned.

⛳️ Requirements

• Up-to-date knowledge of utilization review processes and managed care.

• Understanding of, or willingness to learn, financial management related to Utilization Management functions and reporting.

• Familiarity with quality improvement processes and human resources management.

• Capability to monitor, evaluate, and administer resources, along with recommending resource allocation.

• Ability to identify trends through practice analysis to enhance resource utilization and cost containment.

• Proficient in communicating analytical trends via various reporting mediums.

• Experience in building and leading high-performing teams through recruitment, training, and motivation.

• Strong skills in relationship building and assertive, respectful communication.

• Excellent technical sourcing skills and experience in fast-paced start-up environments are advantageous.

• Proven ability to solve complex, multifaceted problems.

• Capacity for abstract thought.

• Strong sense of urgency, exceptional organizational skills, and prioritization in a dynamic environment.

• Strong analytical, numerical, and reasoning capabilities.

• Participative management style with a team-oriented approach.

• Excellent judgment and ability to identify optimal business-aligned solutions.

• Capability to train, mentor, motivate, and collaborate effectively with team members.

• Proficient in verbal and written communication with administrators, coworkers, and other personnel.

• Ability to create an efficient and effective team-oriented work atmosphere.

• Responsible for conducting performance management reviews for all direct reports.

• Ability to recommend practice changes that enhance Utilization Management efforts.

• Capacity to represent Utilization Management on organizational committees.

• Outstanding relationship management skills.

• Ability to establish credibility and make decisive choices.

• Capability to support organizational preferences and priorities.

• Results-oriented with the ability to balance business considerations.

• Knowledge of multistate workers’ compensation systems.

• Proficient in Microsoft Office products and database programs.

• Ability to produce grammatically correct reports using standard medical terminology.

• Bachelor’s Degree or equivalent work experience required.

• Minimum of 3 years of experience as a Director in a Utilization Management or Utilization Review organization.

• No specific license or certification required.

• Driving is not a necessity.

• Ability to sit, bend, and stoop for up to 8 hours per day in an office environment.

• Ability to lift and move objects weighing up to 10 lbs.

• Willingness to learn technical material.

• Ability to operate a computer, calculator, copy machine, printer, and other office productivity equipment.

• Ability to frequently communicate and exchange accurate information with guests, team members, and vendors.

🏝️ Benefits

• Equal Employment Opportunities for all Team Members and applicants.

• An inclusive environment for all Team Members and applicants.

• Veterans are encouraged to apply.