Director, Clinical Managed Care Programs

  • 16945 Northchase Dr, Houston, TX 77060, USA
  • Employees can work remotely
  • Full-time

Company Description

HealthHelp - A WNS Company (www.HealthHelp.com), is the leader in the field of healthcare utilization & care management. We have gained this position by actively working to change out-of-date practices with a collaborative, non-denial based approach. Our methodology helps payors achieve a higher return on investment, gives providers education programs that better inform physicians, and ensures quality and safety for the patients needing treatment.

HealthHelp’s innovative approach and strong IT capability in specialty benefits management means that staff will move healthcare forward when provided with evidence-based solutions and second opinions. HealthHelp's staff is comprised of healthcare professionals who make a difference every day. HealthHelp has a desire to fill their company with talented and innovative people who want a career path filled with success and personal growth.

Our specialty benefits management services are broad and include, Cardiology, Oncology, Radiology, Radiation Therapy, Sleep Care, and Musculoskeletal Care. HealthHelp has two locations in Houston, one a corporate office and the second a state-of-the art contact center. HealthHelp is also proud to have another such contact center in Albany, New York.

WNS Global Services Inc. (NYSE: WNS) is a global Business Process Management (BPM) leader. WNS offers business value to 400+global clients by combining operational excellence with deep domain expertise in key industry verticals, including Banking and Financial Services, Consulting and Professional Services, Healthcare, Insurance, Manufacturing, Retail and Consumer Packaged Goods, Shipping and Logistics, Telecommunications, Travel and Utilities. Globally, the group’s over 44,000+ Professionals serve across 60 delivery centers in 16 countries worldwide.

Job Description

The Director of Diagnostic Imaging will be primarily responsible for managing operations and resources dedicated to the program. These responsibilities will include:

  • Ensuring program attainment of client performance guarantees and internal operations metrics
  • Driving program efficiencies through operational solutions
  • Ensuring employee performance meets/exceeds standards
  • Ensuring ongoing training/education and client satisfaction in partnership with Client Services
  • Serving as a mentor and subject matter expert 
  • Managing multiple, concurrent projects
  • Ability to handle a large volume of work and lead a team on larger, more complex projects.
  • Ability to gather required information from stakeholders to evaluate objectives, goals, and scope to create feasible solutions
  • Demonstrate and promote a genuine concern for the stakeholder, listen fully and actively to truly understand what others are saying, make decisions based on an understanding of the real stakeholder need
  • Influence stakeholders in a clear, confident and collaborative manner when articulating concepts, challenges, complexities in order to drive standards and best practices.
  • Remaining current on HealthHelp’s platforms, programs and processes and understanding how each can be adapted to meet client needs
  • Collaborate across multiple internal teams (e.g. Product, MEI, Operations, IT) to ensure successful design and delivery of solutions
  • Manage, define and document risks along with mitigation strategies
  • Serve as liaison between technical and non-technical departments in order to ensure that all targets and requirements are met and develops and delivers communication on plans, progress, and ideas to appropriate areas of the organization to include executive management.
  • Manage a team of clinical and non-clinical professionals to ensure optimal product performance, individual and team performance.
  • Define product modifications and/or enhancements required to improve product performance.  Oversee the end-to-end management process to ensure updates are implemented.
  • Work collaboratively with analytic and operational teams to ensure product-specific clinical targets and objectives are translated and reflected in the analytic and operational models.
  • Monitor metrics and performance of each product including, delivering performance reports to client services, sales staff, and clients as needed.
  • Assure all parts of projects come together with quality data and delivered timely
  • Assure ad hoc reports are accurate and timely
  • Assist in sales presentations of current and future programs
  • Responsible for all aspects of specific programs, including planning, budgeting, staffing and performance.
  • Develops programs that meets the needs of the organization and clients and tracks progress against stated goals or milestones.
  • Ensures activities are in compliance with organizational standards and any relevant external regulations.
  • Provides reports and updates to senior management and/or other stakeholders.
  • Create and nourish an environment that drives continuous improvement and optimizes best practices, and foster a culture of excellence based on creativity.

Qualifications

  • 7+ years of experience managing programs, which should bring experience and mentorship to the program lines of business
  • Managed Care experience required
  • Data-driven acumen and mind set required.
  • Bachelor’s Degree in Nursing or Healthcare Related Field or equivalent experience
  • Experienced user of excel; Microsoft office products; knowledge of Tableau and SQL is a plus

Additional Information

All your information will be kept confidential according to EEO guidelines.

Privacy Policy