Social Care Network - Operations Manager (HYBRID)

Care Compass Network•City of Binghamton, NY

7d•Hybrid

About The Position

Reporting to the Social Care Network Director, The Network Operations Manager is responsible for the development and management of the Social Care Network (SCN) program operations. This includes day-to-day management and leadership of the network operations team, as well as network adequacy and network performance.

Requirements

Bachelor’s degree required or minimum 5 years’ experience in healthcare setting requiring routine interaction with internal and external stakeholders and program management responsibilities.
Ability to organize, plan, direct and manage medium to large scale, complex, cross functional, multi-departmental programs to completion with minimal supervision; able to manage multiple concurrent initiatives and effectively prioritize in a dynamic environment.
Excellent communication skills, including the ability to express oneself clearly and concisely.
Proficient in adapting to changing situations and efficiently alternating focus between tasks to support department operations as dictated by business needs.
Ability to assume responsibility and exercise good judgement when making decisions within scope of the position. Utilizes critical thinking skills and has good attention to detail.
Ability to think and work effectively under pressure; ability to effectively serve customers; decision making, maintain a concentrated level of attention to information communicated in person and by telephone throughout a typical workday.
Experience with leading the development of proactive and effective provider relation strategies.
Experience collaborating with teams, vendors, partners, and other key stakeholders with the ability to develop strong working relationships.
Results driven and client focused.
Skilled with personal computer programs such as Microsoft Outlook, Microsoft Office (Word, Excel, PowerPoint, etc.)
Facilitation of meetings either in person or via virtual platforms such as Zoom.

Responsibilities

Oversees and has direct accountability for network operations including management of social care network operations, social care network performance issues, and staff management. Ensures resolution of escalated issues related, but not limited to claims reporting or payment, contract interpretation or parameters, or social care service delivery.
Monitors and ensures the SCN meets network adequacy requirements, making necessary adjustments to meet regulatory standards.
Responsible for establishing and maintaining SCN operational workflows with healthcare ecosystem partners, including screening, determination of service eligibility, referrals and related social needs services.
Ensures the social care network meets the NYS specified requirements of the program. This includes facilitating documentation of network management standards and processes where applicable.
Partners with other entities on individual cases and population health initiatives to improve engagement and outreach to target populations related to social care.
Supports the SCN Director in the timely completion of monthly/quarterly reports for the Department of Health as well as other misc. regulatory reports as necessary.
Monitors performance, develops and implements business solutions to address process and quality gaps, and communicates network strategy and planning to stakeholders (internal and external). Develops and reports on goals and objectives related to efficiency and quality of social care services.
Manages contract performance and supports the development of value-based relationships in support of business strategies.
Identifies issues, trends and opportunities to improve efficiency and/or quality, or to better collaborate with departments and organizations providing services in the SCN.
MUST Maintain HIPAA compliance at all times.