Group Health Operations Manager, RN/LPN

3 days ago

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Dane Street

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Dane Street is a national leader in Independent Medical Exams and Reviews, providing objective, compliant, and timely Independent Medical Examinations, Peer Reviews, and other medical reports. With a large network of over 16,000 physicians, the company offers its services across 25,000 locations and 100 specialties, including Workers' Compensation, Auto, Liability, and Disability claims. Dane Street supports Insurance Carriers, Third Party Administrators, Managed Care Organizations, and Federal/State entities with expert medical analyses, helping them make accurate determinations. The company is recognized for its quality, fast turnaround times, and efficient processes, earning accolades like the NCQA Accreditation in Utilization Management and the Great Place to Work certification.

IMEs • Physician Advisor Reviews • Peer Reviews • Drug Utilization Reviews

51 - 200 employees

⚕️ Healthcare Insurance

📋 Compliance

🏛️ Government

📋 Description

• 100% REMOTE • Oversee and ensure the overall profitability of the regional operations center. • This includes but is not limited to reaching and exceeding financial & referral goals. • Properly managing staffing efficiencies throughout the team. • Managing performance expectations & improvements for existing staff. • Present management with regular reporting on any topic requested by the management team. • Dane Street’s success relies on individual and team contributions every day. • We care for our customers, each other and Dane Street. • It is the responsibility for all of us to maintain a positive working environment that promotes client satisfaction and results. • Driving Revenue Growth • The Operations Manager drives revenue growth by delivering excellent Customer service. • This includes meeting scheduling best practices and turnaround time requirements. • Ensuring the timely delivery of high quality reports. • Managing client inquiries in a timely manner. • Optimizing Physician cost • Ensuring that client invoices adhere to the agreed upon fee schedule. • Overseeing the proper selection of physicians. • Specifically ensuring that the team selects the most appropriate physician based on the claimant’s location, the required specialty, and the most appropriately priced physician based on the client’s fee schedule. • Building relationships with key physicians to ensure panel retention. • Manage Staff Performance and capacity • Monitor key performance metrics of individual Customer Service Representatives (CSR) and Quality Assurance (QA) Specialists. • Ensure the team meets or exceeds 85% of output goals for scheduling and Quality Assurance targets. • Responsible for hiring new staff members based on increased referral volume and/or the addition of new clients. • Conducts performance evaluations that are timely and constructive. • Handles discipline and termination of employees as needed and in accordance with company policy. • Responsible for the overall production, performance, and quality of the assigned region. • Plans and organizes daily activities related to production and operations. • Measures productivity by analyzing performance data, financial data, and activity reports. • Coordinates with other support departments such as human resources, finance, and IT and BA to ensure successful production operations. • Determines labor needs to meet production goals.

🎯 Requirements

• An Associate’s Degree or Bachelor’s Degree is preferred. • RN / LPN License is required. • Business experience in a healthcare and/or insurance setting is preferred. • Business experience in a Worker’s Compensation and/or Auto insurance setting is preferred. • Utilization Review experience is required. • Present exceptional communication skills with a clear understanding of company business lines. • The ability to apply critical thinking, manage time efficiently and meet specific deadlines. • Computer literacy and typing skills are essential. • Supply and support their own internet services. • Maintaining an uninterrupted internet connection is a requirement of all work from home position.

🏖️ Benefits

Join our team at Dane Street and enjoy a comprehensive benefits package designed to support your well-being and peace of mind. • We offer a range of benefits including medical, dental, and vision coverage for you and your family. • Additionally, we offer voluntary life insurance options for you, your spouse, and your children. • We also offer other voluntary benefits which include hospital indemnity, critical illness, accident indemnity, and pet insurance plans. • Employees receive basic life insurance, short-term disability, and long-term disability coverage at no cost. • Our generous paid time off policy ensures you have time to relax and recharge, while our 401k plan with a company match helps you plan for your future. • Apple equipment and a media stipend are provided for remote workspace.