Vice President, TPA Operations
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Posted on:
Yesterday
Vacancies:
1 Vacancy
Job Summary
Exemption Status:
United States of America (Exempt)Exemption Status:
$156839 - $223496 - $290152Pay scale information is not necessarily reflective of actual compensation that may be earned nor a promise of any specific pay for any selected candidate or employee which is always dependent on actual experience education qualifications and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.
Verdegard is looking for extraordinary people to join our team!
Why join Verdegard Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity high performance and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.
Job Description
Summary
The Vice President Operations oversees the operational and quality activities at every level of the organization. Leads operations projects from requirements definition through deployment identifying schedules scopes budget estimations and implementation plans including risk mitigation. The VP of Operations also strategizes process improvements to ensure tasks are completed on schedule.
This position has direct oversight for Claims Operations Stop Loss Customer Service Enrollment Documentation; all aspects of TPA Operations.
Provides leadership in order to recruit manage and retain the necessary resources to successfully perform the duties of the assigned work group(s). Manages work group(s) to achieve service commitments including sustainable measurable accurate reliable and timely execution of project deliverables. Provides day-to-day leadership and direction including developing and administering policies business processes quality standards measurement criteria and operating budgets. Sets high standards and encourages new ideas for improving organizational performance. Takes appropriate corrective action as needed to promote optimal employee performance and maintain low staff turnover.
Essential Duties and Responsibilities include the following. Other duties may be assigned.
- Oversees/leads all functions/operations of Verdegard Administrators.
- Design and directs implementation and execution of operating and service policies guidelines and practices for the enterprise.
- Continually investigates and introduces operational process improvement measures and presents suggestions to the General Manager for consideration.
- Strives to ensure operations move forward & stay current while maximizing innovation.
- Maintain constant communication with management staff and vendors to ensure proper operations of the organization;
- Prepare and present progress updates to appropriate management channels on a regular basis ensuring that innovation is being achieved;
- Coordinate internal and external resources to ensure that projects remain within scope schedule and budget collaborating with staff in various departments;
- Manage data collection for updating metrics to achieve productivity targets eliminate errors and deliver excellent customer service;
- Partner with cross-functional teams to improve proprietary tools and systems;
- Grow the efficiency of existing processes and procedures to enhance and sustain the organizations internal capacity;
- Actively pursue strategic and operational objectives;
- Ensure operational activities remain on time and within a defined budget;
Supervisory Responsibilities
Manages assigned staff in the segment area. Responsible for the overall direction coordination and evaluation of the unit. Carries out supervisory responsibilities in accordance with the organizations policies and applicable laws. Responsibilities include interviewing hiring and training employees; planning assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems. Supports and enforces all company policies and procedures in a fair and consistent manner taking corrective action whenever necessary.
Client Responsibilities
This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written). One must be able to; manage difficult or emotional client situations; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients.
Qualifications
To perform this job successfully an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge skill and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
Education and/or Experience
BA/BS Degree or equivalent; plus 15 years related experience; 15 years of SME in respective area(s); (or equivalent combination of education and experience); and 12 years supervisory experience; Supervisory experience may be substituted with 12 years of MedImpact experience plus an appropriate external leadership training program and internal mentorship with a seasoned leader at the Vice President level or above that must be completed within 12 months in new position.
Computer Skills
Basic PC knowledge including MS Office Suite strongly preferred
Certificates Licenses Registrations
None required
Other Skills and Abilities
- Third Party Administration (TPA) experience in respective area required.
- Must be a consummate team player putting others before self and actively engage stakeholders at all levels.
- Must be customer focused both internal and external to the company.
- Strong Interpersonal skills required.
- Solid Verbal and Written Communications Skills required.
Reasoning Ability
- Ability to define problems collect data establish facts and draw valid conclusions.
Mathematical Skills
- Ability to calculate figures and amounts such as discounts interest commissions proportions percentages area circumference and volume. Ability to apply concepts of basic algebra and geometry.
Language Skills
- Ability to effectively present information and respond to questions from groups of managers clients customers and the general public.
Competencies To perform the job successfully an individual should demonstrate the following competencies:
- Business Acumen
- Directing Others
- Organizational Agility
- Conflict Management
- Drive for Results
- Political Savvy
- Customer Focus
- Innovation Management
- Strategic Agility
- Decision Quality
- Managerial Courage
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this Job the employee is regularly required to sit and talk or hear. The employee is regularly required to stand; walk; use hands to finger handle or feel and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds.
Work Environment
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
This position may regularly be exposed to or encounter moving mechanical parts high precarious places fumes or airborne particles toxic or caustic chemicals outdoor weather conditions risk of electrical shock or vibration. The noise level in the work environment is usually moderate (examples: business office with computers and printers light traffic).
Work Location
This position works on-site at the San Diego Headquarters or other company location (or from a remote location with management approval based on business requirements). Must provide adequate support to internal clients; be available for regular interactions and coordination of work with other employees colleagues clients or vendors; as well as be available to facilitate effective decisions through collaboration with stakeholders.
Working Hours
This is an exempt level position requiring the incumbent to work the hours required to fully accomplish job responsibilities and reasonably meet deadlines for work deliverables. The individual must have the flexibility to work beyond traditional hours and be able to work nights at weekends or on holidays as required. Work hours may be changed from time to time to meet the needs of the business. Typical core business hours are Monday through Friday from 8:00am to 5:00pm.
Travel
Travel to the Tempe AZ site is required every other week.
The Perks:
Medical / Dental / Vision / Wellness Programs
Paid Time Off / Company Paid Holidays
Incentive Compensation
401K with Company match
Life and Disability Insurance
Tuition Reimbursement
Employee Referral Bonus
MedImpact is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego
California. Our solutions and services positively influence healthcare outcomes and expenditures improving the position of our clients in the market. MedImpact offers high-value solutions to payers providers and consumers of healthcare in the U.S. and foreign markets.
Equal Opportunity Employer Male/Female/Disabilities/Veterans
OSHA/ADA:
To perform this job successfully the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are
representative of the knowledge skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
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 intended to be construed as an exhaustive list of all responsibilities duties and skills required of personnel so classified.
Required Experience:
Exec
Key Skills
- Economics
- Internal Audit
- SQL
- Risk Management
- Compliance
- Leadership skills
- Oversight
- Business partner
- AVP
- Requlatory agencies
- Finance
- Accounting
- Potifolio
- Project Management
- Operational Risk
About Company
MedImpact Healthcare Systems fills the prescription for keeping its customers' bottom line in healthy condition. The company provides and manages prescription benefit programs for self-insured employers, health plans, unions, insurers, third-party administrators and others, covering s ... View more
