Director, Out of State Medicaid (REMOTE)
EnableCompAbout the role
POSITION SUMMARY
The Director, OSM is a key leader within the Out-of-State Medicaid function responsible for driving performance, operational execution, and client outcomes across multiple teams. This role oversees Managers, Supervisors, and Revenue Specialists, ensuring alignment of day-to-day operations with departmental strategy, revenue targets, and client expectations. The Director is accountable for setting priorities, optimizing resource allocation, and delivering consistent, high-quality results through effective leadership, performance management, and cross-functional collaboration. In partnership with senior leadership, this role identifies opportunities for continuous improvement, enhances operational efficiency, and develops leadership capability within their span of control to support sustained performance and growth.
THE JOB RESPONSIBILITIES INCLUDE
- Ensure the processes and inventory are in place to hit monthly, quarterly, and annual revenue expectations for the company.
- Lead multiple teams through Managers and Supervisors by establishing daily, monthly, and strategic goals, ensuring alignment to revenue targets and operational priorities.
- Oversee hiring, onboarding, and performance management across assigned teams, ensuring strong leadership capability and team effectiveness.
- Oversee performance management processes, including goal setting, performance reviews, and accountability frameworks across Managers and Supervisors.
- Oversee workload distribution and capacity planning across teams to ensure efficient execution and alignment with business priorities.
- Perform regular audits and client reviews ensuring EC is delivering all requirements to the satisfaction of the client.
- Measures and monitors key performance metrics and delivers concise performance reporting to stakeholders with corrective action plans for variances when appropriate.
- Assists in setting the strategic direction of the Out-of-State Medicaid team and identifies areas of continuous improvement in conjunction with the leadership team.
- Maintain a strong knowledge of insurance billing and reimbursement procedures and regulations.
- Researches and analyzes collections systems processes in Enforcer, including process improvement and SOP enhancement recommendations.
- Coordinate cross-functional resources to execute action plans for assigned accounts and resolve operational challenges impacting performance.
- Oversee the implementation and adherence to quality and productivity standards across teams, ensuring consistency and accountability.
- Set and adjust priorities across teams to ensure optimal resource allocation and focus on the most impactful and profitable work.
- Ensure compliance with HIPAA and related regulatory requirements through oversight of processes, policies, and team adherence.
- Hold Managers and Supervisors accountable for team performance, including productivity, quality, and adherence to workflows and service level expectations.
- Develop and strengthen leadership capability by coaching Managers and Supervisors, building a pipeline of future leaders.
- Provide guidance and oversight on complex performance m
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