[Hiring] Director of Dispute Resolution @Claritev

Role Description

This position is responsible for the oversight and direction of the Arbitration solution. Responsibilities include:

• Providing leadership and decision-making to ensure high-quality service is provided to account management, clients, providers, IDR entities, CMS client's internal customers, and vendor relationships.
• Managing or overseeing all activities with associated units, including developing and implementing policies and procedures on all related systems and workflows.
• Achieving short and long-range business goals and ensuring operating efficiency.
• Directing all facets of the department including staffing, goal setting, budget compliance, product evaluation, and enhancement.
• Coordinating communication and activities between Operations, Sales and Marketing, Human Resources, Network Development, Quality Assurance, IT, and Legal departments.

Qualifications

• 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 negotiation principles.
• Knowledge of commonly used medical data resources.
• Strong 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 effectively.
• Ability to make decisions using limited or incomplete data.
• Advanced proficiency with MS Office and ability to use software, hardware, and peripherals related to job responsibilities.

Requirements

• Direct management of performance to ensure competent staff delivers quality results, including 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.
• 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.
• 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 the 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 worked by team members and address performance issues.

Benefits

• Medical, dental, and vision coverage with low deductible & copay.
• Life insurance.
• Short and long-term disability.
• Paid Parental Leave.
• 401(k) + match.
• Employee Stock Purchase Plan.
• Generous Paid Time Off – accrued based on years of service.
• 10 paid company holidays.
• Tuition reimbursement.
• Flexible Spending Account.
• Employee Assistance Program.
• Sick time benefits – for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year.