Homeoffice Director of Provider Operations bei Claritev
Claritev · Work From Home, Vereinigte Staaten Von Amerika · Remote
- Senior
At Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders -- internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity, and empower each other to illuminate our collective potential.
Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!!
JOB SUMMARY: This position is responsible for owning the day-to-day performance, reliability, and continuous improvement of our healthcare benefits analytics platform. Acting as the operational "control tower", this role will translate business priorities into operational roadmaps, orchestra smooth data implementations and ensure our clients receive fast, intrusted insights from their claims data. Success will be measured by platform uptime, data freshness, and operational KPIs.
JOB ROLES AND RESPONSIBILITIES:
1. Define and meet SLO/SLAs, lead incident response and post-mortem analyses, and collaborate with IT to automate monitoring, alerting, and capacity scaling so the platform remains highly available.
2. Oversee the ingestion, validation, and normalization of claims files. Enforce predictable data-refresh schedules that keep analytics current for internal and client stakeholders.
3. Serve as the operational lead during new client implementations continuously refining processes to shorten time-to-value.
4. Gather real-world data from clients to enhance the efficiency of our implementation process -- both from a data and contracting perspective -- ensuring a frinctionless transition onto the platform.
5. Collaborate with IT to maintain a disciplined release train, coordinate validation testing, and manage rollout and rollback plans to ensure operational stability. Work with Product to publish clear release notes that keep internal teams and clients informed of operational change.
6. Build and track KPIs -- such as implementation cycle time, error rates, operational capacity and costs per user. Create SOPs that drive continuous improvements across platform operations. Own capacity and performance roadmaps, projecting infrastructure needs six to twelve months ahead.
7. Serve as the single point of contact for platform operations across Health Analytic Solutions, IT, Product, Legal and Client Success. Present quarterly operating review and forward-looking improvement roadmaps to leadership.
8. Maintain oversight of the platform's financial operations. Seek to optimize spend across vendors to reduce data redundancies, secure favorable renewals and introduce data.
9. Select, develop, and evaluate staff to ensure the efficient operation of department.
10. Ensure systematic data oriented efforts to improve consumer and/or client services. 50% of this job is related to QM activities.
11. Collaborate, coordinate, and communicate across disciplines and departments.
12. Ensure compliance with HIPAA regulations and requirements.
13. Demonstrate Company's Core Competencies and values held within.
14. Please note due to the exposure of PHI sensitive data -- this role is considered to be a High Risk Role.
15. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.
2. Oversee the ingestion, validation, and normalization of claims files. Enforce predictable data-refresh schedules that keep analytics current for internal and client stakeholders.
3. Serve as the operational lead during new client implementations continuously refining processes to shorten time-to-value.
4. Gather real-world data from clients to enhance the efficiency of our implementation process -- both from a data and contracting perspective -- ensuring a frinctionless transition onto the platform.
5. Collaborate with IT to maintain a disciplined release train, coordinate validation testing, and manage rollout and rollback plans to ensure operational stability. Work with Product to publish clear release notes that keep internal teams and clients informed of operational change.
6. Build and track KPIs -- such as implementation cycle time, error rates, operational capacity and costs per user. Create SOPs that drive continuous improvements across platform operations. Own capacity and performance roadmaps, projecting infrastructure needs six to twelve months ahead.
7. Serve as the single point of contact for platform operations across Health Analytic Solutions, IT, Product, Legal and Client Success. Present quarterly operating review and forward-looking improvement roadmaps to leadership.
8. Maintain oversight of the platform's financial operations. Seek to optimize spend across vendors to reduce data redundancies, secure favorable renewals and introduce data.
9. Select, develop, and evaluate staff to ensure the efficient operation of department.
10. Ensure systematic data oriented efforts to improve consumer and/or client services. 50% of this job is related to QM activities.
11. Collaborate, coordinate, and communicate across disciplines and departments.
12. Ensure compliance with HIPAA regulations and requirements.
13. Demonstrate Company's Core Competencies and values held within.
14. Please note due to the exposure of PHI sensitive data -- this role is considered to be a High Risk Role.
15. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.
JOB SCOPE:
The incumbent is responsible for end-to-end operational health and continual improvement of our healthcare analytics platform. To succeed, the incument must function as a hands-on, data-driven leader who safeguards platform reliability and security, govens HIPAA compliant data ingenstion pipelines; orhestraes disciplined releases and drivens cost-efficient scalability through capacity planning. This role will partner closely with IT, Product, Client Success and Legal to streamline implemenations, shorten time-to-value and translate OKRs into an actional operational roadmap backed by clear KPIs,, documenations and blameless port-mortems. This is a people management job with authority for all HR actions (hiring, firing, discipline, training, etc.)
The incumbent is responsible for end-to-end operational health and continual improvement of our healthcare analytics platform. To succeed, the incument must function as a hands-on, data-driven leader who safeguards platform reliability and security, govens HIPAA compliant data ingenstion pipelines; orhestraes disciplined releases and drivens cost-efficient scalability through capacity planning. This role will partner closely with IT, Product, Client Success and Legal to streamline implemenations, shorten time-to-value and translate OKRs into an actional operational roadmap backed by clear KPIs,, documenations and blameless port-mortems. This is a people management job with authority for all HR actions (hiring, firing, discipline, training, etc.)
