Manager of Operations en Cantex Continuing Care Network

Description

Position Summary

The Manager of Operations will be responsible for overseeing day-to-day operational functions within the health plan, including process optimization, cross-functional coordination, and performance monitoring. This role is critical to ensuring operational efficiency, compliance, and member satisfaction

Qualifications

Key Responsibilities

• Oversee daily operations across departments including Claims, Appeals, Network, and Compliance.
• Identify and implement process improvements to enhance operational efficiency and member experience.
• Monitor performance metrics and prepare reports for leadership review.
• Coordinate cross-functional initiatives to support strategic goals.
• Ensure compliance with CMS, AAAHC, and state regulatory requirements.
• Support transitions of care and continuity planning for high-risk members.
• Participate in Quality Improvement and Compliance Committee meetings.
• Maintain confidentiality and uphold ethical standards in all operational activities.

Qualifications

• Bachelor’s degree in healthcare administration, business, or related field (required).
• Minimum 3 years of experience in health plan operations or managed care.
• Strong analytical, communication, and organizational skills.
• Experience with operational platforms and electronic health records.
• Ability to work independently and collaboratively in a fast-paced environment.

Preferred Attributes

• Prior experience in Medicare Advantage or Special Needs Plans (SNPs).
• Knowledge of ProCare Advantage policies and workflows.
• Commitment to member-centric, trauma-informed care.

Diversity, Equity, and Inclusion are at the heart of Cantex. We are committed to a culture that respects our differences and values the contributions of all people.

We are an Equal opportunity employer; We offer an excellent benefit plan to include 401K with match, CEU reimbursement, vacation, sick, holidays, medical, dental, and supplemental insurance Plans as well as a Highly competitive compensation package.

Please visit cantexcc.com for more information on this location.