Vp Insurance Operations Jobs (NOW HIRING)

OUR MISSION AND PERFORMANCE EXPECTATIONS

The MENTOR Network is a mission driven organization dedicated first and foremost to the children and adults we serve and support.  The Network expects all employees to be mindful of this mission, and to perform their job to its fullest, and as stated in their job description.

The Vice President, Operations Management over-sees service delivery and is responsible for strategic planning, leadership, vision, growth and development, profitability, financial management, human resources, regulatory compliance, quality improvement, stakeholder relations, lobbying and advocacy.

The Vice President, Operations Management is responsible to supervise Executive Directors, Quality Improvement Director and Executive Assistant.  The Vice President, Operations Management has indirect or dotted line responsibility for the Human Resource Director and Business Director. 

The Vice President, Operations Management works full-time in a supervisory capacity, is considered on-call and expected to be available in the event of emergency.  The Vice President, Operations usually works in a state office and is expected to randomly visit programs throughout the year. 

ESSENTIAL JOB FUNCTIONS

To perform this job successfully, an individual must be able to satisfactorily perform each essential function listed below:

Services and Supports

1. Program Planning:  Oversees systems for implementation of program planning; monitors delivery of services and supports; ensures services are consistent, engaging and relevant to the individuals served.
2. Quality Improvement:  Oversees implementation of quality improvement standards and practices; works with the Quality Improvement Vice President and directs the Quality Improvement Director in developing and implementing multi-state strategies to manage and improve quality.
3. Compliance:  Oversees licensing compliance including Network Compliance Plan implementation, timely and accurate documentation; maintaining confidentiality and adherence to individual rights standards; reviews and responds accordingly to adverse action regulatory correspondence and monitors multi-state compliance.
4. Stakeholder Relations:  Implements strategies to maintain and foster positive relationships with individuals receiving services, families, guardians, case managers and payers; oversees implementation of satisfaction surveys, and implements improvement plans as appropriate; implements stakeholder communication plan.
5. Incident Management:   Oversees implementation of Network incident management protocol; manages timely incident reporting and response to higher-level incidents; reviews trends; works with state operations and quality improvement leadership to identify and implement proactive strategies to reduce or eliminate serious incidents in assigned states; directs state teams to address safety concerns, limiting the potential for continued concern or incident.
6. Management of Individuals’ Assets: Implements system to assure protection of individual’s funds and property assuring safety and accuracy; oversees system for auditing, monitoring and reviewing individual financial accounts. 

Health Care

1. General Health Care:  Oversees implementation of health and safety programs, medication administration and dietary planning; implements strategies to limit illness or serious incident and promote access to timely and appropriate medical care; oversees healthcare documentation. 
2. Medications:  Oversees system for medication administration, documentation and security; directs audits of medication administration documentation; directs system to confirm that employees are appropriately certified and trained.
3. Dietary planning:  Directs assigned states to design and monitor food service in accordance with dietary and regulatory requirements, including for special needs, occasions and individual choice.

Stakeholder Relations

1. Public Relations:  Manages relationships and communications with the general community, neighbors, government, competitors and other outside organizations.
2. Payer and Government Relations:  Maintains and fosters positive relationships with multiple state government authorities and referral agencies such as counties, regional centers, managed care contractors, and government administrators.
3. Related Organizations:  Participates in advocacy on behalf of individuals served or supported; joins and takes a leadership role in state and national trade associations, advocacy or other pertinent organizations.
4. Political Involvement:  Develops and implements public policy strategy; participates in building relationships with legislators and government officials; makes political contacts and lobbies on behalf of the industry, company and persons receiving services.

Personnel

1. Management:  Oversees implementation of human resource practices including recruitment, retention, training, scheduling, payroll processing, record keeping and management of employees; conducts monthly meetings with state team members including Executive and State Directors, Business Director, Quality Improvement Director, Human Resource Director and other personnel.
2. Recruitment and Hiring:  Works with the Human Resource Director in developing and managing recruitment and hiring strategies; hires Executive and State Directors, Quality Improvement Director and other team members in consultation with the Operating Group President and department vice presidents.
3. Coaching, Discipline and Termination: Oversees multi-state management and implements Network employment practices; conducts annual evaluations for multi-state team and oversees evaluation process for all employees; in consultation with human resource personnel, reviews written warnings and approves involuntary terminations for state level personnel.
4. Training:  Organizes and oversees orientation and training programs; monitors training compliance and documentation.
5. Employee Safety: Responsible for workers’ compensation and employee safety programs and monitors compliance; directs return to work implementation.

Growth and Development

1. Oversees strategic and blueprint planning to grow business across multiple states; incorporates growth and budgetary planning; reviews best practices for dissemination across states; maintains a healthy and productive business showing year over year growth.
2. Directs business development and operations personnel in efforts to grow revenue, maintain margin and meet annual growth plans; encourages state and regional development to serve new populations and drive geographic and service line expansion; encourages and approves new start or other core development initiatives.
3. Promotes relationships with payers, competition and other stakeholders; identifies opportunities by following industry trends, responding to payer need and requests for proposal.
4. Identifies potential candidates for tuck-in or acquisition; assists with diligence and integration planning; assumes management of acquired entities.
5. Directs strategy across multiple states to increase census, maintain occupancy, improve daily attendance and maximize utilization.

Financial Management

1. Responsible for the financial performance of business units; reviews financial statements; reviews purchasing practices.

1. Billing and Utilization:  Oversees billing to assure accuracy and compliance in practices and documentation; monitors utilization between authorization, provision of service, and billing.
2. Expense Management:  Monitors spending and purchasing practices to maintain budgetary compliance; monitors staffing and program spending; approves proposals for capital improvement.
3. Compensation:  Works with the Operating Group President to develop and implement fair and equitable, wage plans; approves wage status changes for multi-state, and state teams and according to wage guidelines and budgetary parameters.

Maintenance

1. Maintenance and Repair: Oversees system to maintain facilities, grounds, furnishings and equipment, in good repair and working order, and in accordance with regulatory standards; oversees environmental safety planning; develops longer term plans for capital improvement.
2. Housekeeping:  Oversees system to maintain neat, clean and safe service environments, including grounds; assures age appropriate and esthetic decoration.
3. Vehicles:  Directs system to assure vehicles are clean, safe and well maintained; oversees system of training procedures for maintenance and safe operation of vehicles and transport of individuals.

Other

• Performs other related duties and activities as required. 

SUPERVISORY RESPONSIBILITIES

• Supervises direct reports and oversees indirect staff members of the multi-states.

Minimum Knowledge and Skills required by the Job

The requirements listed below are representative of the knowledge, skill, and/or abilities required to perform the job: 

Education and Experience: 

• Bachelor's degree; Master’s degree in Business or Human Services is preferred. 
• Fifteen to eighteen years of related experience with significant management experience in the human services industry. 
• Additional education or experience where required by regulatory authority.

Certificates, Licenses, and Registrations:

• Current driver's license, car registration and auto insurance if driving on the behalf of the Company or providing transportation to individuals receiving services. 
• Other licensure or certification where required by regulatory authority.

Other Skills and Abilities:

• N/A

Other Requirements:

• Travel as needed

Physical Requirements:

• Light work.  Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects.  If the use of arm and/or leg controls requires exertion of forces greater than that for sedentary work and the worker sits most of the time, the job is rated for light work.

AMERICANS WITH DISABILITIES ACT STATEMENT

External and internal applicants, as well as position incumbents who become disabled, must be able to perform the essential job functions either unaided or with assistance of a reasonable accommodation to be determined on a case by case basis via the interactive process.