Director of Dispute Resolution

Claritev•New York, NY

2d•$140,000 - $160,000

About The Position

This position is responsible for the oversight and direction of the Arbitration solution. This position is responsible for providing leadership and decision making to ensure high quality service is provided to account management, clients, providers, IDR entities and CMS client's internal customers and vendor relationships. Also responsible for managing or overseeing the management of all activities with the associated units, including developing and implementing policies and procedures on all related systems and work flows to ensure achievement of the department's service and quality standards. This job is responsible for providing the type of leadership, management, and vision necessary to achieve short and long-range business goals and to grow the business unit as well as ensuring operating efficiency. The Director is responsible for directing all facets of the department including staffing, goal setting, budget compliance, product evaluation and enhancement, and policies/procedures to ensure smooth and efficient operations. This job is also responsible for strategic planning and budget decisions. Coordinate communication and activities between all areas within Operations, Sales and Marketing, Human Resources, Network Development, Quality Assurance, IT and Legal departments.

Requirements

Bachelor Degree or minimum 5 years’ experience in the healthcare industry with 2 years in a leadership role with people management responsibilities.
Required licensures, professional certifications, and/or Board certifications as applicable.
Excellent organizational, analytical and independent decision-making skills
Demonstrated problem solving skills with the ability to manage multiple priorities and meet associated timelines
Knowledge of provider billing and collection practices.
Knowledge of effective negotiations principles.
Knowledge of commonly used medical data resources.
Communication (verbal and written), managerial, interpersonal, organizational, time management, customer service/sales, problem solving, leadership, strategic, analytical, tactical and execution skills.
Ability to prioritize and manage time.
Ability to make decisions using limited or incomplete data.
Ability to use software, hardware, and peripherals related to job responsibilities, including advanced proficiency with MS Office

Responsibilities

Direct management of performance to ensure competent staff delivers quality results. This includes training, mentoring, motivating, and overseeing staff performance.
Develop, implement and manage both short- and long-term goals, objectives, policies and procedures based on current and future trends and legislative requirements. Stay abreast of industry and/or customer changes and communicate as appropriate.
Compile, analyze, and report on trends to include performance improvement initiatives and exceptional client delivery.
Oversight and development of operational relationships and performance for clients, account management and other stakeholders.
Identify opportunities for performance improvement and operational efficiencies.
Manage departmental and team budgets including expenses, cost containment, and profitability.
Provide direction and guidance to other levels of management, through delivery of instructions and direction to staff on individual cases and the creation and distribution of goals and standards to team members regularly.
Act as a subject matter expert internally for the Team and other departments within the Company.
Select, develop, and evaluate staff to ensure the efficient operation of department.
Collaborate, coordinate, and communicate across disciplines and departments.
Ensure compliance with HIPAA regulations and requirements.
Demonstrate Company's Core Competencies and values held within.
Perform weekly Soft Audits on cases work by team members and address performance issues.