Director of Provider Network Operations

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The Director of Provider Network Operations (PNOPS) provides the leadership and management to ensure that provider network operations within the Occupational Health Services (OHS) business line have the proper operational controls, administrative and reporting procedures, and people systems in place to effectively grow the organization, ensuring financial strength and operating efficiency. The position accomplishes this through a respectful, constructive and energetic style that complements the leadership team and is guided by the business and financial objectives of the Acuity OHS Team. This position carries a high degree of responsibility and judgment in overseeing the provision of high-quality services delivery on an ongoing basis. The Director of Provider Network Operations reports to the Service Business Line (SBL) Lead, OHS.

Duties and Responsibilities:

• Provide day-to-day leadership and management of the Acuity Provider Network that mirrors the adopted mission and core values of the Acuity Team. This includes providing direction and coaching to individuals who lead the various teams within Provider Network Operations and executes in coordination with the vision and strategy set by the OHS service business line leader.
• Institutes continuous improvement programs intended to support provider network growth, stability, and quality. The Director of PNOPS will execute strategies to manage default operations and manage daily operations ensuring provider network access and quality, customer experience productivity, service, cost control, and department goals are achieved.
• Responsible for executing against financial and operational goals and assesses organizational effectiveness in meeting these goals through the development, measurement, and reporting of KPI's and operational scorecards.
• Leads regularly scheduled team meetings to ensure open, two-way communication between Provider Network Operations and Exam Management departments.
• Reviews reports on operations with managers on a regular basis to ensure provider network performance and contract adherence, advises on all aspects of provider network operations with managers.
• Develops and mentors team members from a careering perspective; ensuring annual appraisals are completed in a timely manner; goals and work plans are collaboratively (where applicable) and consistently implemented and executed; performance issues are addressed fairly and appropriately; consulting with management/corporate support as appropriate.
• May lead or participate in interdepartmental project groups or task forces to integrate activities, communicate issues, obtain approvals, resolve problems and maintain specific level of knowledge pertaining to new developments, new task efforts, contract awards, and new policy requirements.
• Supports marketing/sales objectives and efforts as requested
• Uses continuous quality improvement methods to identify provider network access and/or performance gaps, develops innovative solutions and implements changes for provider network enhancement and program support.
• Provides timely, accurate and complete reports on the operating condition of the provider network and responsible for regular executive and employee communication to report on the effectiveness of the operation to promote strong execution, alignment, and accountability.
• Provides leadership, expertise,and insight to SBL Leader on all operational matters making recommendations for new business and product strategies or human capital investments.
• Develops solid people systems, processes, and development programs resulting in a highly engaged workforce and a strong and positive culture.
• Represent the business with provider network partners, clients, and investors, negotiates terms and contracts in support of our operating principles and practices and short- and long-term needs of the business.
• Ensure compliance monitoring and internal controls are in place, including processes for management of operational risk, in accordance with Acuity Policies and regulatory standards.
  Conducts operational assessments and surveys in support of creating, enhancing, and implementing operational efficiencies within PNOPS.
• Lead and develop an effective team through communication, performance management, employee development plans, and reward/recognition practices.
• Provides assistance to the programs and program management when developing action plans or responding to corrective action plans and oversees implementations in support of the OHS delivery model.
• Attends and participates in all staff meetings, training courses, workshops, conferences and any other staff-related activities required by the position.
• Maintains thorough knowledge of and comply with all rules, laws, procedures, and policies relevant to duties.

Qualifications:

• Bachelor's Degree in related field with a minimum of 8 years of provider network management experience and 12 years progressive leadership roles and responsibilities
• Demonstrated successful track record in growing provider networks and successfully managing turnarounds through the building and management of outstanding partnerships and teams.
• Strong understanding of business acumen, best practices and technologies to build an appropriate platform for effectively growing the business in coordination with operational and financial requirements.
• Ability to research and analyze problems, identify solutions, and take appropriate action to resolve problems using independent judgment and decision-making processes.
• Ability to work independently and collaboratively.
• Able to develop tools, monitor, and formulate reports for the continuous improvement of long-range goals and objectives.
• Knowledge of and ability to interpret government & commercial contractual requirements, as well as Acuity, Policies and Procedures pertaining to our contracts, service level agreements, and all other pertinent rules and regulations.
• Clean criminal background check.
• Travel up to 25% of the time.
• Ensures safe operating conditions within the OHS business line.
• Leads, supports and participates in the OHS strategic planning meetings, training, and goals and objectives planning.
• Assists in the active implementation of Acuity & OHS initiatives to ensure compliance with mandated regulations/standards.
• May serve on the Acuity Quality, ISO, Safety, and Wellness Committees.
• Perform duties in a safe manner. Follows the corporate safety policy.
• May be assigned to other tasks as needed.

Preferred Qualifications:

• Master's degree in business management or related field
• Medical Services / Occupational Health Industry background
• Experience with Provider Service Agreement Negotiations
• Experience with Fee Schedules & Medicare Rate Procurement of Providers
• Experience with building and maintaining an International Network
• Experience with building and maintaining a Specialty and IME Provider Network
• Project Management Professional (PMP Certified)
• Previous Occupational Health Provider Network & Provider Relations Experience

Physical Requirements and Work Conditions:

• Work is normally performed in a typical interior/office work environment.
• Work involves sitting and standing for prolonged periods of time.
• May require bending and lifting up to 30 lbs.

Acuity International is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration without regard to race, color, sex, national origin, age, protected veteran status, or disability status.

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