Director Insurance Operations Jobs in Washington

Description:

From intake to outcomes, CareMetx is dedicated to delivering industry-leading patient access solutions and support services that help patients quickly start and stay on specialty therapy treatments. We provide scalable, efficient digital hub services for pharmaceutical companies and healthcare providers, streamlining workflows with seamless integration for patient enrollment, consent, and prior authorization. Our best-in-class patient support services enhance every step of care, connecting patients, providers, and brands to drive better outcomes and accelerate time-to-therapy.

JOB TITLE: Director, HUB Operations

POSITION SUMMARY:

Under the general direction of Senior Operations leadership, the Director is responsible for managing the reimbursement and other hub services related to specialty pharmaceutical, biotech and medical device manufacturer clients. The Director is responsible for the oversight of all team members providing the full range of services for specific programs. The position will participate in other related projects and perform other functions as may be required from time to time.

PRIMARY DUTIES AND RESPONSIBILITIES:

• Manage the existing team for operations related to manufacturer programs
• Responsible for the management of the client program manager(s)
• Participate in strategic and tactical planning sessions
• Make recommendations in the development of long-term strategies
• Present strategic and operational plans for the development of new
• Participate in proposal writing, contracting, client presentations, and pricing
• Involved with the development of policies, standard operating procedures and work instructions for manufacturer
• Responsible for overseeing the recruitment, training and management of program teams
• Maintain regular and reliable attendance, including being present, on time, and prepared for work as scheduled.
• Performs other related duties as assigned.

EXPERIENCE AND EDUCATIONAL REQUIREMENTS:

• College degree preferred
• Requires broad knowledge and training in the fields of healthcare, specialty pharmacy and reimbursement
• Requires a minimum Seven (7) years of experience
• At least 5 years in a progressive management role
• A minimum experience in the pharmaceutical industry is required
• General knowledge of reimbursement, patient assistance programs, database elements and functionality; operational policies and processes
• Dynamic leader who can energize multidiscipline work teams to learn and apply new skills and /or techniques to respond to the business needs
• Knowledge of full service call center programs preferred

MINIMUM SKILLS, KNOWLEDGE AND ABILITY REQUIREMENTS:

• Strong customer/client management background
• Exceptional project management skills with experience in organizing, planning and executing projects from vision through implementation
• Good analytical, conceptual and problem solving skills with demonstrated track record in new concept development for various projects
• The ability to manage multiple tasks along a parallel process
• Strong decision making capabilities
• Critical thinking skills, creative and innovative solutions to internal or external client needs
• Strong industry and business knowledge
• Strategic thinker with long term planning experience
• Ability to communicate effectively both orally and in writing
• Possess strong interpersonal and leadership skills, be able to develop and grow talent
• Strong organization agility, be able to manage team through change and lead by example
• Ability to proficiently use computer and good knowledge of Microsoft Office

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 accommodations 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.
• The employee must occasionally lift and/or move up to 10 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 accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.

SCHEDULE:

• Must be flexible on schedule and hours
• Some travel may be required

CareMetx considers equivalent combinations of experience and education for most jobs. All candidates who believe they possess equivalent experience and education are encouraged to apply.

At CareMetx we work hard, we believe in what we do, and we want to be a company that does right by our employees. Our niche industry is an integral player in getting specialty products and devices to the patients who need them by managing reimbursements for those products, identifying alternative funding when insurers do not pay, and providing clinical services.

CareMetx is an equal employment opportunity employer. All qualified applicants will receive consideration for employment and will not be discriminated against based on race, color, sex, sexual orientation, gender identity, religion, disability, age, genetic information, veteran status, ancestry, or national or ethnic origin.

Requirements: