Insurance Operations Manager Jobs in Baton Rouge, LA

JOB PURPOSE OR MISSION: Responsible for the day-to-day management, operation and accountability for a functional area. Makes decisions that could seriously affect the division, department and/or GHS System's financial and performance objectives and strategic results. Develops and monitors the budget for area. Direct reports may include supervisors, and/or staff employees including responsibility for performance reviews, hiring, disciplinary actions and terminations. Performs duties for the age population served, as defined department's scope of service.

PERFORMANCE CRITERIA

CRITERIA A: Everyday Excellence Values - Employee demonstrates Everyday Excellence values in the day-to-day performance of their job.

PERFORMANCE STANDARDS:
Demonstrates courtesy and caring to each other, patients and their families, physicians, and the community.
Takes initiative in living our Everyday Excellence values and vital signs.
Takes initiative in identifying customer needs before the customer asks.
Participates in teamwork willingly and with enthusiasm.
Demonstrates respect for the dignity and privacy needs of customers through personal action and attention to the environment of care.
Keeps customers informed, answers customer questions and anticipates information needs of customers.

CRITERIA B: Corporate Compliance - Employee demonstrates commitment to the Code of Conduct, Conflict of Interest Guidelines, and the GHS Corporate Compliance Guidelines.

PERFORMANCE STANDARDS
Practices diligence in fulfilling the regulatory and legal requirements of the position and department.
Maintains accurate and reliable patient/organizational records.
Maintains professional relationships with appropriate officials; communicates honesty and completely; behaves in a fair and nondiscriminatory manner in all professional contacts.

CRITERIA C: Personal Achievement - Employee demonstrates initiative in achieving work goals and meeting personal objectives.

PERFORMANCE STANDARDS
Sets goals and action plans to achieve objectives.
Completes assignments following accepted procedures and practices, even when workloads and demands are high.
Adheres to high moral principles of honesty, loyalty, sincerity, and fairness (integrity).

CRITERIA D: Performance Improvement - Employee actively participates in Performance Improvement activities and incorporates quality improvement standards in his/her job performance.

PERFORMANCE STANDARDS
Strives to continuously improve all aspects of the business operation through quality improvement initiatives.
Assures the accuracy of data, work, or information and contributes ideas and suggestions to improve approaches, methodologies, and productivity.
Willingly participates in organization and/or department quality initiatives.

CRITERIA E: Cost Management - Employee demonstrates effective cost management practices.

PERFORMANCE STANDARDS
Demonstrates effective time management to promote productivity and cost efficiency.
Uses material goods wisely, is conscious of the environment and is accountable for prudent use of our talents and financial resources.
Develops appropriate budget(s) for areas of responsibility.
Effectively manages budget(s) and continually monitors key cost areas.

CRITERIA F: Leadership - Employee demonstrates effective leadership by developing standards of performance, determining areas of responsibility and accountability and delegating authority.

PERFORMANCE STANDARDS
Invites input from others and shares ownership and recognition.
Inspires people by example and influences them to do and be their best.
Inspires and encourages teamwork.
Consistently executes applicable company policies, rules and regulations.

CRITERIA G: Operations Management - Employee demonstrates the ability to give clear and concise instructions as to assignment objectives and methods, and reviews results at all critical points.

PERFORMANCE STANDARDS
Establishes clear work objectives that prioritize and focus employee efforts.
Staffs work area with appropriate numbers of qualified employees.
Allocates and delegates work effectively to make efficient use of resources and employee capabilities.

CRITERIA H: Performance Management - Employee demonstrates an awareness of employees' development needs to improve work effectiveness, and insures that training and related programs are available to meet these needs.

PERFORMANCE STANDARDS
Provides opportunity for skill development for employees.
Provides ongoing performance feedback to employees and takes corrective action when necessary.
Completes and conducts performance appraisals by established review date.

CRITERIA I: Patient & Employee Safety - Employee actively participates in and demonstrates effective patient and employee safety practices.

PERFORMANCE STANDARDS
Employee effectively communicates, demonstrates, coordinates and emphasizes patient and employee safety.
Employee proactively reports errors, potential errors, injuries or potential injuries.
Employee demonstrates departmental specific patient and employee safety standards at all times.
Employee demonstrates the use of proper safety techniques, equipment and devices and follows safety policies, procedures and plans.

JOB FUNCTIONS

ESSENTIAL JOB FUNCTIONS include, but are not limited to:

1. Ensures that objectives of the department or area of responsibility are administered.

PERFORMANCE STANDARDS:
Ensures that established priorities for department are carried out on a daily basis.
Ensures that goals and objectives of the department are consistent with the GHS's philosophy.
Ensures that departmental measures for processes and expectations are carried out on a daily basis.
Uses alternative methods of providing services to reduce department-operating costs.
Coordinates staffing needs of the department with regards to market/seasonal changes.

2. Maintains an organized department to ensure efficiency, accuracy of work, and information flow.

PERFORMANCE STANDARDS:
Monitors department operations and recommends changes as needed.
Ensures the efficient operation of the department.
Utilizes available staff to maximize the effectiveness of the work performed.
Reviews the compilation and analysis of department data as necessary.

3. Demonstrates effectiveness in directing the activities of the department.

PERFORMANCE STANDARDS:
Ensures staff members adhere to policies and procedures necessary to achieve department objectives.
Establishes and maintains an effective working relationship with management and other departments.
Maintains an effective performance improvement program.
Manages supervisory and department staff members.

4. Demonstrates effectiveness in controlling the daily activities of the department.

PERFORMANCE STANDARDS:
Reviews the daily productivity of the department.
Provides management and policy interpretation to supervisors.
Communicates effectively and expresses information clearly.
Encourages staff participation and communication in decision-making.
Exhibits responsiveness to others in the organization at all levels.

5. Manages the day-to-day operations of clinic staff and business office.

PERFORMANCE STANDARDS:
Works through supervisors within clinic to ensure effective and efficient processes are developed and followed.
Coordinates interviews and hires to maintain proper staffing, initiates and follows up on disciplinary procedures or terminations when necessary.
Ensures new employees are oriented to clinic operation, policies and procedures and trained using appropriate training protocols and training checklists.
Ensures performance reviews for all clinic staff are completed prior to due dates.
Ensures all control logs and other documentation are maintained according to established guidelines.
Ensures charges, payment and adjustments of computer totals are reconciled to appropriate manual logs and bank deposits on a daily basis.

6. Prepares clinic's operating and capital budgets in accordance with organizational goals and monitors adherence.

PERFORMANCE STANDARDS:
Prepares annual operating and capital budgets in conjunction with clinic physicians and/or BRGP management.
Compares actual performance to established budgets and completes monthly budget variance analysis, reports and explanations.
Reports or alerts management of any trends or problems that need to be addressed by the corporate office.

7. Performs all other duties as assigned.

SPECIFIC EXPERIENCE REQUIREMENTS
5 years experience in physician clinic management
Multi-clinic experience preferred

SPECIFIC EDUCATIONAL REQUIREMENTS
College degree preferred.

SPECIAL SKILL, LICENSE AND KNOWLEDGE REQUIREMENTS
Possesses the ability to deal tactfully with physicians, personnel, patients, family members, visitors and the general public. Must have knowledge of information systems design and operations. Must be able to do extensive walking and standing.

HIPAA REQUIREMENTS:
Maintains knowledge of and adherence to all applicable HIPAA regulations appropriate to Job Position including but not limited to: electronic medical records with limit to job function, patients demographics, information related to patient location relating to information given/excluded from the media.

SAFETY REQUIREMENTS:
Maintains knowledge of and adherence to all applicable safety practices appropriate to Job Position including but not limited to: incident reporting, exposure control plans, hand washing, environmental rounds to ensure safety.