PHRN Assistant Manager, Operations

The primary responsibility of this role is to oversee the day-to-day operations of a team of nurses who assist their onshore counterparts with administrative case management tasks. To monitor performance according to established standards and conducts performance evaluations. They will be responsible to plan, direct, supervise and evaluate workflow as well as to coordinate work activities to achieve volume expected and meet operational requirements.

Essential Functions:

Clinical Management

• Oversees the implementation of Highmark Clinical Case Management Support including but not limited to Case Management (CM) screening/Telephonic Outreach/Program Enrollment/Task Support for Case Management and monitors daily performance to ensure business goals are met and compliance with Highmark policies and procedures is maintained
• Implements clinical policies & procedures in accordance with NCQA, URAC, state and federal standards and mandates
• Serve as a content model expert and mentor to the team regarding practice standards, quality of interventions, problem resolution and critical thinking
• Ensure implementation and monitoring of best practice approaches and innovations to better address the member's needs across the continuum of care
• Protects the confidentiality of member information and adheres to company policies regarding confidentiality
• Manages resources responsible for identification of members, development and implementation of care plans, enhancement of medical appropriateness and quality of care and monitoring
• Communicates productivity expectations, balance workload (e.g., daily team meetings to discuss new referrals), monitor efficiency and initiate control measures to minimize variances in workload over time
• Ensures the team's understanding and use of information system capability and functionality
• May have responsibility for their own case load work

Team Management

• Select staff using clearly defined requirements in terms of education, experience, technical and performance skills
• Assesses developmental needs and collaborates with others to identify and implement action plans that support the development of high performing teams
• Establish an environment and work style that promotes the concept of teamwork, cross product integration, and continuum of care thinking that results in strong performance
• Articulate performance expectations and team objectives while collecting and interpreting balanced measure to evaluate individual staff and team performance
• Lead change efforts while managing transitions within a team
• Create a positive work environment by acknowledging team contributions, soliciting input, and offering personal assistance when needed
• Accountable for maintaining compliance with Human Resource policies and procedures and implements them at the employee level
• Sedentary work involving periods of sitting, talking, hearing, work requires visual acuity to perform close inspection of handwritten and computer-generated documents as well as a PC monitor
• Typical office working environment

Organizational Relationships

• Primary Internal Interaction

A. Reports to:
o Lead Assistant Manager

C.Collaborates with:
o Enabling Function Staff (HR Personnel, IBMS Staff, IT Resource, Clinic Staff)
o MIS and WFM, to monitor schedule, productivity and attendance
o Supervisors, for the purpose of reporting performance, seeking assistance and support for any training concerns, monthly evaluation of performance, developing training modules, and updating of training curriculum
o Quality team, for the purpose of collaborating, identifying top drivers, clarifying audits and updating process management

2.Primary External Interaction
A.Stateside Counterparts
B.Product Customer (Providers, Members, Vendors)

Skills

Technical Skills

• Superior knowledge of MS Office applications (PowerPoint, Excel, Word)
• Essential knowledge in internet usage and efficient email handling
• Basic familiarity in use of projector and web-based training
• Requisite background in contact center administration
• Systematic scheduling and good estimation of training timeline
• Competent Training Management
• Determines system utilization requirements and testing systems
  Process Specific Skills
• Demonstration of profound familiarity and technical skill relevant to the process
• Continuous update and development of training module
• High-quality knowledge on developing instructional modules and teaching aids
• Able to present course information in a simplified manner
• Able to identify with and comprehend data and new information
• Execution of providing customer service
  Soft Skills
• Above average verbal and written communication skills
• Self-disciplined and results oriented
• Coaching and mentoring skills
• Flexibility and urgency to handle pressure
• Analytical skills
• Ability to multi-task

Core Competencies

Client Focus

• Understands & anticipates clients business needs concerns & issues, and monitors progress to achieve results
• Benchmarks best in class performance and creates and achieves aggressive standards
• "Sponsors" the client's interest within the organization and influences action, where required to achieve client objectives
• Builds personal rapport, and is able to influence client thinking, and decision making
• Creates an internal environment where client is the focus of the business through appropriate communication, recognition and rewards
• Thinks of ways to enhance the client's business
• Partake in client visits

Collaboration and Teamwork

• Creates a "solutions" mindset as different from a functional one and emphasizes common goals and objectives
• Encourages best practice sharing and collaboration to optimize team processes and constantly keeps the business and client / internal customer at the forefront
• Encourages & demonstrates respect for others and what they bring to the table
• Shows openness to feedback and willingness to change
• Effectively manages diversity within the team. Demonstrates sensitivity and respect for differences in culture/ businesses
• Proactively surfaces and resolves conflicts and interpersonal breakdowns
• Proactively shares information, progress and credit to constantly reinforce teamwork within the team
• Creates a healthy balance between individual performance/credit and team performance/credit
• Develops and manages relationships with key stakeholders and aligns their efforts towards common business objectives

People Management

• Proactively creates a talent pipeline for the organization by participating in processes for identifying and developing talent within the teams
• Seeks to find solutions to succession planning in the team to ensure continuity of business
• Creates challenging standards of performance for the team and reviews performance periodically, fairly, and objectively
• Makes the time to coach team members
• Identifies development areas and helps the individuals and the team to improve their performance and enhance their potential
• Creates an environment of meritocracy by rewarding and recognizing performance and talent
• Has an eye for talent and participates actively in the process of talent acquisition
• Demonstrates a keen interest in retention management and employee engagement and proactively creates plans and strategies for improvement
• Talks the walk and enrolls others
• Keeps and helps others create a healthy work life balance

Superior Implementation

• Gets things done; takes ownership & accepts accountability
• Creates specific plans to meet the goals, seeks to accomplish measurable results
• Anticipates problems before they occur and finds solutions
• Has a strong sense of urgency for getting work done, acts within deadlines, shows a significant level of effort, persistence, and time commitment to achieve goals and meet deadlines
• Able to rise to the occasion and multi-task when required
• Takes initiative to build new capability for implementation in the future

Analytical Skills

• Interprets data to create meaningful information and analysis
• Generates multiple alternatives and is able to determine the most optimum course of action under the circumstances
• Is able to learn from the experiences of others
• Very good at understanding of new concepts, methods and ideas
• Evaluates patterns and the credibility of sources of information

Feedback

• Builds and maintains atmosphere where coaching, counseling and feedback are considered essential for better performance
• Focuses on problem, not person
• Effectively differentiates and identifies behaviors that can negatively / positively influence the process
• Clearly and effectively communicates the detrimental / positive behaviors to the person receiving the feedback
• Encourages commitment, openness, and responsiveness
• Demonstrates openness and active listening by seeking clarification, rephrasing statements and summarizing to check understanding
• Offers non-judgmental responses, encourages exploration of feelings, concerns and aspirations
• Provides positive follow-up to ensure performance/behavior improvement

Conformance with Policies/Compliances

• Knowledge of applicable policies/regulations/compliances applicable to the function/organizational/industry/ Government and Client across geographies
• Understands in-depth the various internal policies/compliance norms including Contractual/Safety/ISO/SOX and incorporates the requirements in day-to-day work
• Proactively responds to applicable regulatory requirements by putting plans in place for implementation and follow ups including filing returns and other documentary procedures
• Creates systems and checks to maintain these compliances and ensures maintenance of clear and precise records per the requirements
• Keeps abreast with latest rulings/notifications/contractual changes and informs those concerned about the impact of the new legislations on the business
• Applies knowledge of statutes and legal provisions to fully assess the impact of various legislation on the business and to get maximum advantage for the organization within the legal framework
• Reviews compliance adherence on a regular basis

Communication

• Excellent presentation skills creating the necessary understanding and impact and influencing the desired action
• Communicates the vision, values and strategy of the company, and the progress with conviction and enthusiasm both internally and externally
• Listens and seeks to understand. Is sensitive to bottom-up feedback and uses it effectively
• Is adept at using various communication media/ channels
• One to one, open houses, focus groups, team meetings
• Converts raw data into meaningful information
• Writes clearly, succinctly, and correctly
• Avoid unnecessary use of jargons or complicated language
• Demonstrates the ability to organize and present information to suit the needs and understanding of the audience

Operations Management

• Demonstrates in-depth knowledge of key performance indicators
• Develops and applies tactics to deliver service level agreements on a day-to-day basis (forecasting workload/providing requisite staffing/managing day to day technology issues etc.)
• Establishes systems and processes to ensure sustained levels of performance
• Uses appropriate tools / mechanism to report/review performance and take corrective action where required
• Demonstrates ability to anticipate potential problems and take appropriate corrective actions
• Uses quality techniques/tools to improve processes on a day-to-day basis
• Effectively responds to client requirements at a short notice by realigning priorities
• Converts reports into meaningful analysis and quantifiable actions

Qualifications:

• Must have active PHRN license
• 1 year experience in a support role (Team Lead / QA / Trainer, etc.)
• 1 year bedside experience
• Can start ASAP

What's your expected monthly basic salary?

Human Resources & Recruitment

MAQ Talent Solutions Inc.

MAQ Talent Solutions is Human Resource Management Company specializing in Talent Acquisition and placement of best fit talents. Our recruitment and selection is complemented with a strong background investigation. Our candidates are prescreened consistently, to ensure the integrity of the organization and the safety of employees.

The people behind MAQ Talent Solutions have been practicing Recruitment and Detective & Investigation for decades. No one can better understand the demands given to Hiring Managers but the people who have gone through the same challenges and responsibilities, exhibiting the same competencies. Because of this, our HR solutions are built upon a history of long years of experience and deep-rooted passion for Human Resources especially Recruitment.

MAQ Talent Solution was borne out of the desire to carry on MAQ Research Inc's legacy in the industry. Hence, it endeavors to be acknowledged by its clients for the services rendered with integrity, quality, simplicity & flexibility. As we get to know our clients' needs to have a variety of options when it comes to selecting the best fit talent, we have come to value more the significance of delivering peace of mind that comes from making an intelligent factual-based decision regarding talent acquisition and management. Because of that, MAQ Talent Solutions desires to deliver that peace of mind to the business by providing recruitment processes that are reliable, cost effective and adheres to the high standards of professionalism and business ethics

MAQ Talent Solutions Inc.

MAQ Talent Solutions is Human Resource Management Company specializing in Talent Acquisition and placement of best fit talents. Our recruitment and selection is complemented with a strong background investigation. Our candidates are prescreened consistently, to ensure the integrity of the organization and the safety of employees.

The people behind MAQ Talent Solutions have been practicing Recruitment and Detective & Investigation for decades. No one can better understand the demands given to Hiring Managers but the people who have gone through the same challenges and responsibilities, exhibiting the same competencies. Because of this, our HR solutions are built upon a history of long years of experience and deep-rooted passion for Human Resources especially Recruitment.

MAQ Talent Solution was borne out of the desire to carry on MAQ Research Inc's legacy in the industry. Hence, it endeavors to be acknowledged by its clients for the services rendered with integrity, quality, simplicity & flexibility. As we get to know our clients' needs to have a variety of options when it comes to selecting the best fit talent, we have come to value more the significance of delivering peace of mind that comes from making an intelligent factual-based decision regarding talent acquisition and management. Because of that, MAQ Talent Solutions desires to deliver that peace of mind to the business by providing recruitment processes that are reliable, cost effective and adheres to the high standards of professionalism and business ethics

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What can I earn as an Assistant Operations Manager