KEPRO
7750_8017213
Posted: 1 Days ago
Tampa, FL 33601
Tampa, Florida, US
Date Posted: 1/14/2021 12:00:00 AM
KEPRO is a rapidly growing national quality improvement and care management organization. We work to ensure that over 20 million people receive the right care, at the right time, in the right setting. KEPRO is seeking resumes for a highly experienced professional.
Director of Operations
Summary Description
Manages the day-to-day operations for the HRSA Contract to include assuring timely achievement of contract deliverables, providing oversight of operational policy/procedure, assuming fiscal responsibility for revenue margins, ensuring excellent customer service/support and provide oversight/support for internal/subcontractor staff.
Accountabilities
Establish/maintain effective relationships with HRSA staff; COR, Team Lead, Executive, and support.
Work collaboratively with interdisciplinary teams; analytics, IT, finance/accounting, FTCA deeming.
Work collaboratively with the VP, Quality Oversight to organize/direct the overall operations of the HRSA contract. Imperative to the role is strict adherence to organizational policy and procedure, federal guidelines/requirements.
Ensure compliance with and achievement of all contract deliverables per the contract SOW.
Collaborate with Finance/Accounting to ensure budgetary compliance, analyze variances, and assume fiscal responsibility for revenue margins.
Supervise all staff; ensure compliance with organizational P&P, assess training needs, address employee performance, develop CAPs as necessary, complete annual performance appraisals by established deadlines.
Actively participate in new employee recruitment, onboarding, orientation, supervision.
Actively participate in the recruitment of subcontractors, i.e., peer reviewers, deeming. Ensure completion of training requirements and collaborate with contracts in securing subcontracting agreements.
Prepare quarterly Board of Director PowerPoint presentations; present/discuss with executive staff as required.
Attend and facilitate monthly Kepro Operational/HRSA team meetings, and other meetings as required.
Serve as Chair of the LQIC; attend/facilitate quarterly LQIC meetings, annually review/update team P&P.
Review/approve all monthly/quarterly/annual/ad hoc/deeming/actuarial reports prior to distribution to HRSA. (And all other reports as required by the contract)
Complete monthly claims auditing/QIP ensuring results are captured in Kepro’s metrics database.
Actively participate with Medical Claims Review Panel (MCRP) preparation; review/approve agenda entries, recruit/retain/train/schedule panel presenters, approve presenter timesheets.
On a daily basis, assess and evaluate the work que (Tickler) and adjust staffing schedules to ensure production of reports within the HRSA-established deadlines.
Prepare monthly budget variance reports; participate in weekly/monthly finance meetings to ensure fiduciary compliance/program financial success.
Review/approve all timesheets including those submitted by internal staff, peer reviewers, all subcontractors (Deeming, Program Advisor, Actuarial, etc.)
Interface with HRSA’s Deeming Program team to ensure a complete/timely/accurate/successful deeming cycle; attend all meetings during the annual cycle to include all trainings, weekly prep, weekly subcontractor, others as required by HRSA.
Collaborate with the Medical Director to ensure quality and timeliness of Expert Medical Reviewer (EMR) reporting.
The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.
Supervisory Responsibility
RN Nurse Reviewers
Administrative Assistants
Manager, HRSA FTCA Deeming Program
Program Clinical Advisor
Health Center Program Advisor
Peer Reviewer/Deeming Subcontractor staff
Qualifications
Graduation from School of Professional Nursing.
BSN required, advanced degree preferred; MSN, Juris Doctorate, Certification in Healthcare Administration.
Prior nursing experience in an acute care setting.
Claims Management/Risk Management preferred.
Current, valid, unencumbered Pennsylvania RN license.
Knowledge, Skills, Abilities
Demonstrable experience in personnel management; recruitment, onboarding, employee development, performance management.
Decisive leadership with excellent decision-making skills.
Ability to participate as a team member fostering collaborative decision-making among leadership, committees, teams or work groups of diverse composition.
Attentiveness to detail/accuracy, organized.
Effective communication skills.
Ability to anticipate critical issues and design effective interventions.
Knowledge of the U.S. healthcare industry; preferably with experience in both public and private sector.
Commitment to the corporate mission and strategic plan.
Knowledge of business development, strategic planning, tactical implementation and creation of business partnerships.
Experience
10 years of experience in healthcare/risk management field.
3 to 5 years of recent management experience.
Previous experience writing Quality Improvement Reports, i.e., medical chronologies, claim/risk Management/reserve reports.
Previous experience establishing accurate loss reserves in a medical negligence claims setting.
Previous credentialing/deeming experience.
Public and private sector healthcare experience and/or involvement in providing services to government or commercial programs.