27 days old

Sr. Director, HCS Third-Party Liability Operations

Performant Financial
Sunrise, FL
  • Job Code
Performant Financial Corporation
Performant Corporation is an Equal Opportunity Employer (Minorities/Females/Disabled/Veterans).

Sr. Director, HCS Third-Party Liability Operations
Job Code:2020-50-6A-004
Location:Remote - Sunrise, FL
Status:Regular Full Time
The Sr. Director of Third-Party Liability (TPL) Operations is a key member of the Healthcare Services organization. The role directs oversees and drives business operations for Performant’s healthcare services eligibility-related solutions.  Leverages depth and breadth of industry and operational experience to evolve practices and grow service delivery capability.

•Assume P&L ownership over all Third-Party Liability (TPL) Medicaid and Medicare lines of business (LOB).
•Leverage TPL and operational expertise to identify and correct deficiencies and improvement opportunities in organizational LOB knowledge, processes and procedures, and other infrastructure to increase performance on existing accounts.
•Lead implementation and operations of new TPL Medicaid and Medicare accounts.
•Develop business plans for full scalability, including funding, staffing, and technology modeling
•Executes on business plans, in accordance with internal standards and relevant statements of work.
•Prepares reports and overseas operational activities for line of business clients.
•Applies in depth level of expertise in development of operational policies, procedures and workflows.
•Proactively identifies opportunities for process improvement, efficiency, resolving problems, preparing and completing action plans. 
•Develops and manages a team of leaders and operational staff members.
•Leads by example and performs duties adhering to all Company policies and procedures.
•Establishes standards for performance monitoring and accountability (productivity/quality/compliance), communicates job expectations, trends, documentation, ensures timelines and metrics are met. 
•Supports strategy by conducting needs assessments, capacity planning, cost/benefit analyses, staff modeling, and other analysis. 
•Uses excellent communication skills in order to influence a wide range of internal and external audiences.
•Maintains professional and technical knowledge and leverages relevant market insights, trends, and best-practices.
•Occasional travel to Performant office(s), client office(s), or other business/industry meetings. 
•Other duties as assigned
Required Skills and Knowledge:
•Depth and breadth of comprehensive knowledge of Medicaid / Medicare / Other TPL business models and products.
•Working knowledge of requirements gathering, ETL processing, data matching, and databasing
•Demonstrated ability to meet top and bottom line revenue targets for a rapidly expanding business Strong process, project and program management skills.
•Demonstrated ability to develop and manage high performing teams in a dynamic, fast-paced environment. 
•Proven ability to deliver business results, maintain high customer satisfaction and compliance adherence.
•Mind-set of continuous improvement and adapts quickly and effectively to change
•Excellent interpersonal skills for interfacing with all levels, both internally and externally.
•Effective communicator, both verbally and in writing, with energetic and approachable style.
•Demonstrated use of excellent judgement and ability to make sound decisions, exhibiting initiative and intuitive thinking, in the best interest of the company.
•Strong problem solving and analytical skills.

Physical Requirements: 
•Performs duties in a busy standard office environment with moderate noise level. (or home-based Telework environment in accordance with Company policies and procedures).
•Sits or stands at a desk, reaching as needed to use office equipment.
•Makes and returns calls using an office phone system or company issued cellular phone.
•Views a computer monitor, types on a keyboard and uses a mouse.
•Reads and comprehends information in electronic (computer) or paper form (written/printed).
•Types frequently, but not constantly, using a keyboard and mouse.
•Occasionally lifts/carries/pushes/pulls up to 10 pounds.
Education and Experience:
•Bachelor’s degree in relevant field or equivalent combination of education and experience.
•12+ years in healthcare industry with increasing responsibility relevant to the position. 
•7+ years working with healthcare eligibility data, including extensive experience with  Medicaid / Medicare / Other TPL business models and products.
•7+ experience leading multiple lines of business with P&L responsibilities.
•Accomplished track record demonstrating the knowledge and skills required for the position.
Other Requirements
-Must submit to and pass pre-employment (and during employment) background check, including, but not limited to, criminal background checks; must not have any felony convictions or specific misdemeanors, nor on state/federal debarment lists.
-Must submit to and pass drug screen.
-Performant is a government contractor. Certain client assignments for this position may require additional background and/or clearances.

Job Profile is subject to change at any time.

Performant Financial Corporation is an Equal Opportunity Employer. Performant Financial Corporation is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law.


Posted: 2020-06-11 Expires: 2020-07-10

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Sr. Director, HCS Third-Party Liability Operations

Performant Financial
Sunrise, FL

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