Job Title: Director, Network Services (Case Management and Call Center)
Reports to: Senior Director of Network
- Preferred Master’s Degree in business, health administration &/or social work/human services
- Two years of supervision experience
- Preferred Two years of Business experience in the social service sectors
- Preferred experiences in call center environment and software
- Excellent general IT skills – high-level user
Partners in Care Foundation is growing, and we are looking for a Director of Network Services to join our team. They will manage and supervise staff from multiple programs that provide services for multiple health plans and organizations including outreach and engagement center.
- Ensure all referrals are addressed within contract-required timeline
- Develop contingency plans to ensure coverage of all contract-required geographies, languages/cultures, and specialties (e.g., mental health, homeless, disabled)
- Establish and maintain positive relationships with PAH members
- Recruit additional network partners as needed
- Manage PAH network member contract negotiations (with Contracting Director), communication, credentialing (insurance, HIPAA, staff qualifications, etc.) and onboarding. Notify contract holders when new network members are added.
- Develop and implement training of Network staff both internal and external.
- Assist clinical/training manager and quality senior director to establish and implement quality monitoring and improvement systems. Assist clinical training manager with creation and implementation of a plan to prepare network members for accreditation standard 10 – delegation.
- Provide clinical feedback to coaches on a case by case basis if needed. Clinical review of documentation that goes back to health plans.
- Plan and oversee convening of PAH member meetings – in person and telephonic – for top management, supervisors, and coaches
- Work with network members to track actual costs and provide input into pricing and contract renegotiations.
- Work with consultants to create and implement business/marketing plans for PAH Network
- Participate in contract operations meetings
- Serve as account manager as assigned
- Be familiar with all contract requirements and timelines and ensure compliance across the network
- Participate in sales and planning meetings for new contracts to facilitate continuity in implementation phase
- Help write grants to support network operations, training, meetings, and quality improvement while volume is being built.
- Collaborate on preparation for Joint Operations Committee and Clinical Operations meetings
- Participate in regular Grand Rounds and Clinical Rounds calls with nurse case managers
- Work closely and collaboratively with Health Services, Health Self-Management, and Finance divisions
- Oversee leadership team, multiple contracts, as well as network providers. Including direct and indirect staff.
- Ensure department operates within budget; use creative approaches to problem-solving for processes that exceed budgeted time allotments. Help network members improve efficiency to ensure their payment covers expense.
- Project management responsibility for onboard or improving programs in the network department. Monitoring overall progress and use of resources to ensure timely competition.
- Responsible for Network quality by establishing and enforcing quality standards to ensure that contractional requirements are being met as well as client satisfactions are met.
- Manages Engagement Center (Call center) with a blended inbound/outbound multi-campaign environment.
- Ensure service levels are consistently maintained to optimize customer and client satisfaction
- Ensure adequate staffing commensurate with call arrivals
- Build processes for observation and monitoring of the call center staff to confirm high level customer services and sales techniques are being utilized.
- Drive the pursuit off company and client-imposed goals including enrollments and conversion from enrollment to “show rate”.
- Responsible for all dialer software’s and interactions.
- Managing and supervising staff from multiple programs that provide services for multiple health plans and organizations including outreach and engagement center.
Partners in Care Foundation is an equal opportunity employer. We are committed to complying with all federal, state, and local laws providing equal employment opportunities, and all other employment laws and regulations. It is our intent to maintain a work environment which is free of harassment, discrimination, or retaliation because of age, race (including hair texture and protective hairstyles, such as braids, locks, and twists), color, national origin, ancestry, religion, sex, sexual orientation, pregnancy (including childbirth, lactation/breastfeeding, and related medical conditions), physical or mental disability, genetic information (including testing and characteristics, as well as those of family members), veteran status, uniformed service member status, gender, gender identity, gender expression, transgender status, arrest or conviction record, domestic violence victim status, credit history, unemployment status, caregiver status, sexual and reproductive health decisions, salary history or any other status protected by federal, state, or local laws. All qualified applicants will receive consideration for employment and reasonable accommodations may be made to enable qualified individuals to perform the essential functions of the position.