Director Of Insurance Operations Jobs in Micronesia

Mon - Fri

Pay Range

Areas of oversight include: Nursing Resource Office, Clinical Resource Unit, Psychiatric Consult Nurses, Short Stay Unit, 2W Med Surg, 6S Rehab and Hemodialysis scope.

Major Responsibilities:
Coordination and administration of all operational aspects to provide effective quality care for patients.

Plans and directs the administrative and operational functions to maximize patient revenues, attract new patients, and meet regulatory requirements.
Prepares and administers the departmental operating and capital budgets to ensure sufficient funds and personnel to accomplish departmental objectives within approved financial guidelines.
Monitors department productivity levels and work functions to ensure proper staff and resource utilization. Ensures the development of staff within the assigned areas.
Facilitates the care management process for assigned patient care centers in conjunction with care management and system goals.
Identifies areas for operational efficiency improvement and implements changes.
Assumes 24 hour accountability for the daily clinical and administrative functions for assigned patient care centers.
Development and implementation of strategic plans than integrate the goals of Advocate Health Care and Advocate Christ Medical Center's Mission, Values, Philosophy, and Strategic Plan(s).

Develops and implements long and short range goals and objectives, policies, and procedures to meet demands for service in keeping with strategic plans for each assigned area; this is inclusive of planning of the interface with other functional areas.
Facilitates patient focused care with ongoing research and review of state-of-the-art models of care delivery, spanning continuum of care.
Integrates the functions of assigned areas and promotes the inter-relations between assigned departments and other hospitals and Advocate facilities to maintain consistent standards of care.
Plans and implements new services. Determines fiscal feasibility of establishing new or expanded services including the reimbursement component, profitability, staff requirements, and availability of services.
Conducts competitor analysis to determine program growth and market share and to keep abreast of trends or changes. Manage the development and implementation of business plans and objectives that support the effectiveness of existing and new programs as well as supports the growth of the hospital.
Develops and presents new program/ideas. Coordinates implementation of the new program as well as the marketing, goals, and objectives which provide for the resources necessary to carry out the future growth of the hospital.
Develops and oversees the compilation of statistical information to be used for current operations and future plans.
Development and ongoing maintenance of collaborative relationships with department managers/directors, physicians, system-wide contacts and related external contacts in order to meet hospital/system objectives.

Develops and maintains relationships with physicians as well as other hospital managers/directors and staff.
Monitors impact of services on all other hospital services. Notifies other areas impacted by new and/or expanded services in order that planning for those services can be accomplished.
Acts as liaison between physicians and other hospital departments to facilitate problem resolution.
Develops and maintains various relationships with external clients/contacts to promote and insure program growth.
Serves as representative to department meetings as assigned.
Works with program directors of Medical Education to ensure residency review requirements related to space, ancillary, and professional staff, and other resources are met.
Collaboration with peers systemwide to develop standardized protocol, products, contracts and expected outcomes.
Development and implementation of policies, procedures, and standards which follow quality management, DNV, IDPH, CDC, OSHA, and other external guidelines.

Facilitates and oversees the quality management programs for units and their adherence with system standards and regulatory agencies.
Monitors changes in DNV/governmental standards and make changes in CMC policy and procedure accordingly.
Ensures that assigned areas have instituted an effective Performance Improvement Program and that the program integrates with all related committees and processes.
Promotes patient safety by reporting of issues through established channels and participating as requested in safety initiatives.
Responsible for professional and personal growth and development.

Keeps abreast of current standards of care/standards of regulatory bodies.
Maintains memberships in professional and community organizations.
Participates in activities to enhance professional growth and development by involvement in professional organizations and continuing education.
Leads division in customer and associate satisfaction initiatives to achieve steady improvement in scoring levels.

Uses enhanced satisfaction as a consistent key element in all change processes
Utilize staff teams along with management as a decision maker in satisfaction initiatives.
Continually assess controllable factors in achieving higher satisfaction levels and facilitate measures to improve.
Licensure:
Nurse, Registered (RN)
Education/Experience Required:
Master's degree in health care related field. Advanced degree in Business Administration, Hospital Administration or a health care related field 5 years in healthcare management or project management.
Knowledge, Skills & Abilities Required:
Demonstrated management skills, including ability to work well with others, team building and conflict resolution skills, effective communication and presentation skills. Ability to work across all lines of management and staff to promote good relationships among departments. Strong knowledge of healthcare finance.

Current RN license required in the state in which employed. Specialty Certification
Physical Requirements and Working Conditions:
Ability to travel locally as well as long distance travel.
This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

Our CommitmenttoYou:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more - so you can live fully at and away from work, including:

Compensation

• Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training

• Premium pay such as shift, on call, and more based on a teammate's job

• Incentive pay for select positions

• Opportunity for annual increases based on performance

Benefits and more

• Paid Time Off programs

• Health and welfare benefits such as medical, dental, vision, life, andShort- and Long-Term Disability

• Flexible Spending Accounts for eligible health care and dependent care expenses

• Family benefits such as adoption assistance and paid parental leave

• Defined contribution retirement plans with employer match and other financial wellness programs

• Educational Assistance Program

Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview.