Director of Dispute Resolution

Director of Dispute Resolution

 

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 the oversight and direction of the Arbitration solution. This position is responsible for providing leadership and decision making to ensure high quality service is provided to account management, clients, providers, IDR entities and CMS client's internal customers and vendor relationships. Also responsible for managing or overseeing the management of all activities with the associated units, including developing and implementing policies and procedures on all related systems and work flows to ensure achievement of the department's service and quality standards. This job is responsible for providing the type of leadership, management, and vision necessary to achieve short and long-range business goals and to grow the business unit as well as ensuring operating efficiency. The Director is responsible for directing all facets of the department including staffing, goal setting, budget compliance, product evaluation and enhancement, and policies/procedures to ensure smooth and efficient operations. This job is also responsible for strategic planning and budget decisions. Coordinate communication and activities between all areas within Operations, Sales and Marketing, Human Resources, Network Development, Quality Assurance, IT and Legal departments.

 

 

DUTIES

1. Direct management of performance to ensure competent staff delivers quality results. This includes training, mentoring, motivating, and overseeing staff performance.
   2. Develop, implement and manage both short- and long-term goals, objectives, policies and procedures based on current and future trends and legislative requirements. Stay abreast of industry and/or customer changes and communicate as appropriate.
   3. Compile, analyze, and report on trends to include performance improvement initiatives and exceptional client delivery.
   4. Oversight and development of operational relationships and performance for clients, account management and other stakeholders.
   5. Identify opportunities for performance improvement and operational efficiencies.
   6. Manage departmental and team budgets including expenses, cost containment, and profitability.
   7. Provide direction and guidance to other levels of management, through delivery of instructions and direction to staff on individual cases and the creation and distribution of goals and standards to team members regularly.
   8. Act as a subject matter expert internally for the Team and other departments within the Company.
   9. Select, develop, and evaluate staff to ensure the efficient operation of department.
   10. Collaborate, coordinate, and communicate across disciplines and departments.
   11. Ensure compliance with HIPAA regulations and requirements.
   12. Demonstrate Company's Core Competencies and values held within.
   13. 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. Perform weekly Soft Audits on cases work by team members and address performance issues.

 

COMPENSATION

The salary range for this position is $140-160K.  Specific offers take into account a candidate’s education, experience and skills, as well as the candidate’s work location and internal equity.  This position is also eligible for health insurance, 401k and bonus opportunity.

 

Qualifications

REQUIREMENTS

* Bachelor Degree or minimum 5 years’ experience in the healthcare industry with 2 years in a leadership role with people management responsibilities.
* Required licensures, professional certifications, and/or Board certifications as applicable.
* Excellent organizational, analytical and independent decision-making skills
* Demonstrated problem solving skills with the ability to manage multiple priorities and meet associated timelines
* Knowledge of provider billing and collection practices.
* Knowledge of effective negotiations principles.
* Knowledge of commonly used medical data resources.
* Communication (verbal and written), managerial, interpersonal, organizational, time management, customer service/sales, problem solving, leadership, strategic, analytical, tactical and execution skills.
* Ability to prioritize and manage time.
* Ability to make decisions using limited or incomplete data.
* Ability to use software, hardware, and peripherals related to job responsibilities, including advanced proficiency with MS Office

 

BENEFITS

We realize that our employees are instrumental to our success, and we reward them accordingly with very competitive compensation and benefits packages, an incentive bonus program, as well as recognition and awards programs.  Our work environment is friendly and supportive, and we offer flexible schedules whenever possible, as well as a wide range of live and web-based professional development and educational programs to prepare you for advancement opportunities.

 

Your benefits will include:

• Medical, dental and vision coverage with low deductible & copay
• Life insurance
• Short and long-term disability
• Paid Parental Leave
• 401(k) + match
• Employee Stock Purchase Plan
• Generous Paid Time Off – accrued based on years of service
  • WA Candidates: the accrual rate is 4.61 hours every other week for the first two years of tenure before increasing with additional years of service
• 10 paid company holidays
• Tuition reimbursement
• Flexible Spending Account
• Employee Assistance Program
• Sick time benefits – for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year, unless the laws of the state in which the employee is located provide for more generous sick time benefits

 

 

EEO STATEMENT

Claritev is an Equal Opportunity Employer and complies with all applicable laws and regulations.  Qualified applicants will receive consideration for employment without regard to age, race, color, religion, gender, sexual orientation, gender identity, national origin, disability or protected veteran status.  If you would like more information on your EEO rights under the law, please click here.

 

 

APPLICATION DEADLINE

We will generally accept applications for at least 5 calendar days from the posting date or as long as the job remains posted.

 

 

 

 

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