Mgr Business Operations

Highmark Health

About The Position

JOB SUMMARY This job plans, manages and oversees the implementation of the strategic business and functional infrastructure, continuous process improvement initiatives across multiple functional units, and transformational support to include design throughout implementation to assure people/process/technical solutions align with strategic initiatives while driving consensus among business units. Designs activities including the documentation, management and oversight of end to end workflow process analysis assuring improved productivity, cost effectiveness, appropriate embedding of key performance indicators and appropriate controls for both regulatory and compliance considerations. ESSENTIAL RESPONSIBILITIES Perform management responsibilities including, but not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity. Plan, organize, staff, direct and control the day-to-day operations of the department; develops and implements policies and programs as necessary; may have budgetary responsibility and authority. Oversee the definition, scoping, chartering efforts for business process analysis/design projects related to process improvement initiatives assuring optimal business and functional delivery of the strategic delivery framework. Manages the business consultation services which include research, analysis facilitation, process modeling, and business process improvement techniques to propose and implement business and system solutions that meet strategic objectives and compliance requirements. Establish and maintain strong working relationships across business unit/area level of management continuing to promote and continually broaden the level of business knowledge and the impact of quality/process improvement projects and programs. Oversee planning sessions with business owners to improve business processes and to prioritize and drive process re-engineering initiatives including process ownership and governance. Oversee the analytic processes, data points, and controls to determine sub-optimal performance, communicate findings clearly and effectively and make recommendations for improvement. Identify root causes of problems and demonstrate the ability to development and make recommendations for solutions to mitigate root cause. Oversee the vendor management relationships with applicable business unit subcontractors assuring compliance with regulatory and accrediting entities and oversees the business unit compliance activities with regulatory and accrediting entities Other duties as assigned or requested.

Requirements

High School Diploma or GED
5 years' experience in designing and implementing operational processes to make improvements or solve business challenges
3 years experience leading projects or managing people.
Thorough understanding of business operations, requirements processes, and business modeling concepts and demonstrated business knowledge required to evaluate corporate-wide implications of changes to products and programs to assess impact for all lines of business
Software skills, including use of Microsoft Office software and other applications
Demonstrated and highly proficient verbal communication skills to articulate ideas clearly to various audiences
Time management, organizational and multi-tasking skills necessary to work in a fast-paced environment
Teamwork-focused/collaborative work style

Nice To Haves

Bachelor’s Degree
Six Sigma Black or Green Certification
3 years ofmanaged care and/or call center operations experience
3 years of Medicaid/Medicare experience
3 years of NCQA experience

Responsibilities

involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.
Plan, organize, staff, direct and control the day-to-day operations of the department; develops and implements policies and programs as necessary; may have budgetary responsibility and authority.
Oversee the definition, scoping, chartering efforts for business process analysis/design projects related to process improvement initiatives assuring optimal business and functional delivery of the strategic delivery framework.
Manages the business consultation services which include research, analysis facilitation, process modeling, and business process improvement techniques to propose and implement business and system solutions that meet strategic objectives and compliance requirements.
Establish and maintain strong working relationships across business unit/area level of management continuing to promote and continually broaden the level of business knowledge and the impact of quality/process improvement projects and programs.
Oversee planning sessions with business owners to improve business processes and to prioritize and drive process re-engineering initiatives including process ownership and governance.
Oversee the analytic processes, data points, and controls to determine sub-optimal performance, communicate findings clearly and effectively and make recommendations for improvement.
Identify root causes of problems and demonstrate the ability to development and make recommendations for solutions to mitigate root cause.
Oversee the vendor management relationships with applicable business unit subcontractors assuring compliance with regulatory and accrediting entities and oversees the business unit compliance activities with regulatory and accrediting entities
Other duties as assigned or requested.