Job Description: Vice President of Operations
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DELTA DENTAL OF NEW MEXICO
Mission
To promote the health and wellness of the people, families, and communities of New Mexico through accessible, affordable, quality, value-based, and innovative dental coverage and ancillary services.
Purpose
We are dedicated to improving the overall health & smiles of the people we serve.
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JOB POSITION: Vice President of Operations
CLASSIFICATION: Exempt
The Vice President of Operations is responsible for managing and providing support to enterprise initiatives, including system and staff support for all customers and client groups. Responsible for operational plans and organizing and directing the work of the Operations team that includes customer service, claims administration and customer/client/group enrollment services. Develops and executes department budget and provides significant input and execution into the Company’s strategic plan. The Vice President of Operations is a member of the Senior Management Team.
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Reporting: Chief Executive Officer
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PRIMARY JOB RESPONSIBILITIES: The following are upheld by the Vice President of Operations:
· Articulate and Communicate Company Vision and Values - Role model and live the company values and behaviors. Know the company mission and objectives and continually communicate and reinforce these to fellow Team Members. Inspire and motivate others toward achieving the mission and living the core values.
· Assure Communication & Clarity of Direction - Sets standards for performance and quality. Empowers others to act. Holds people accountable to outcomes. Demonstrates effective communication strategies (appropriate method, channel, time, frequency). Communicate industry developments and best practices across the Company. Analyzes impact of external developments to the organization.
· Assure Accountability & Necessary Resources - Assist fellow managers/leaders in designing and implementing business structures, processes and procedures that focus on performance and accountability.
· Team Member Development and Performance Management - Develop and evaluate department staff, drive individual and team accountability for achievement of department and individual goals and objectives.
· Capacity for Story Telling - Develop the capacity for storytelling across the organization, synthesize findings in a way that leads to specific action.
· Action orientation - Leads organizational performance improvement initiatives. Drive departmental innovation and optimize opportunities to achieve success. While taking risks consistent with defined risk tolerances, to achieve strategic business objectives.
· Assure an Engaged Capable Operations Team is in Place and Operating Effectively – Lead, recruit, develop, motivate, and manage the Customer Service, Claims and Group Enrollment teams. Drive individual and team accountability for achievement of department and individual goals and objectives.
· Assure Accurate and Timely Claims Processing/Adjudication - Ensure claims processing is delivered timely, efficiently, and accurately. Work with enterprise to identify and review trends for evidence of fraud, waste, and abuse.
· Management & Oversight of “Affiliation” Provided Services – Assure efficient, timely, and quality services provided through the “affiliation agreement(s)” with Renaissance Health Service Corporation (the Enterprise) and its affiliates. To assure “best in class” service to DDNM stakeholders.
· Develop, Leverage & Maintain Industry & Service Relationships - Create, develop, and maintain strong and positive relationships with current and prospective customers and other external contacts and stakeholders while providing excellent service overall.
· Product Design, Management & Evaluation – In conjunction with the Business Intelligence Unit and Sales & Marketing analyze current product and plan performance (financial, structural, regional, etc.) by group size and product line. Analyze financial performance and pricing structure at the product/size level.
· Catalyst to Improved Market Based Plan Benefit Structure(s) – In collaboration with Senior Management leverage the findings and observations of your staff to assist in the improvement/competitiveness of the benefits offered to DDNM stakeholders/customers. Actively provide input on benefit structure and related service costs for various dental plans. Monitor plan utilization and proactively provide input on corporate policies based on ongoing review of utilization and other data.
· Successful Implementation of Strategic Initiatives – Proactively participate in the development and Implementation of company strategic business objectives. Effectively translate strategic business objectives to actionable departmental objectives. Communicates departmental objectives, priorities, measures, and targeted departmental and company outcomes to Company staff.
· Effective Project Management - Evaluate, prioritize, and assign projects to staff including projects involving other departments, plans or the enterprise fairly, balancing workload while developing employee deficiencies and leveraging employee strengths and skills.
· Effective Policies and Procedures - Develop, recommend, and enforce policies, procedures, guidelines, and standards of operations.
· Governmental Programs – Effectively support the evaluation, strategic direction(s), processes, and implementation of potential government programs (i.e., Medicaid, Medicare, Etc.).
· Define & Implement Required Timely Analytics – Proactively work with the Vice President of Administrative Services to align the organization on an agreed upon set of analytics, nomenclature, and data sources that result in a single source of truth in assigned functional areas/departments and align with established financial reporting and budget process norms.
· Assure Service Driven Metrics are Proactively Managed – Develop and implement performance standards across the Customer Service, Claims and Group Enrollment Teams. Drive individual and team accountability for achievement of department and individual metrics, predefined standards, and objectives.
· Demonstrate and Leverage Analytical and Conceptual Thinking - Align Company/Departmental activities to achieve strategic business objectives and effective Enterprise Risk Management. Meet fiscal and budgetary objectives. Identify and develop strategies to meet current and future needs of customers and key stakeholders.
· Be a Catalyst to Process Improvement / Effective Performance Processes & Procedures Management - Monitor “department” performance and develop and implement corrective action plans in collaboration with department owners. Design and implement business structures and procedures that focus on performance and accountability.
· Other Duties, Projects, Tasks - Performs/leads other tasks, duties, and responsibilities, as assigned by the CEO.
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PERFORMANCE REQUIREMENTS:
The following are required of the Vice President of Operations:
· Contribute to development of Strategic Plan initiatives and successfully execute on those assigned to the Operations department.
· Achieve and/or exceed the performance standards for Customer Service, Claims Administration; and Client/Group Administration.
MINIMUM QUALIFICATIONS:
The following are expected of the Vice President of Operations:
Knowledge/Skills/Abilities
1. Knowledge of rules, regulations, and procedures related to dental health plan administration.
2. Knowledge of all company, enterprise and DDPA practices and products as well as existing and emerging competitor activities in our markets.
3. Work independently and collaboratively.
4. Maintains knowledge of health plan industry and best marketing practices in the dental insurance industry by tracking trends, developments, new products, skills, services, and tools.
5. Demonstrated ability to lead, influence, and inspire teams and stakeholders.
6. Analyze problems and identify solutions; shows flexibility and resourcefulness in approaching a typical problem. Able to analyze and interpret information in both statistical and narrative form. Creative and analytical problem-solving skills individually and in a group environment.
7. Prioritize multiple demands and projects with effective time management skills.
8. Demonstrated ability to effectively use computer software applications for work processing.
9. Excellent written, verbal, and listening skills; effective presenter and public speaker.
10. As a manager of people, ability to explain Company objectives in plain language.
11. Educate and influence departments and customers.
12. Adapting to change with minimal or no advance notice, including changes in how business is conducted, and work is accomplished, with no diminishment in work performance.
13. Proactively assess market and competition.
14. Develop and maintain courteous and effective working relationships with customers, vendors and/or external and internal stakeholders.
EDUCATION: Bachelor’s degree in business or related field required.
EXPERIENCE: Position requires at least seven (7) years of experience in a health/dental Insurance Operations department or function (e.g., customer service, claims adjudication, group/client administration and utilization review). Five (5) years of people supervisory experience. May accept any suitable combination of education, training, or experience.
Job Type: Full-time
Pay: $170,000.00 - $220,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Parental leave
- Referral program
- Tuition reimbursement
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Work Location: In person
