Director, Business Operations

 
Position: Director, Business Operations

Job ID: 403596

Location: US-TX-Houston

Department: Business Operations - Admin

Talent Area: Professional - Non-Clinical

Full/Part Time: Full time

Regular/Temporary: Regular

Shift: 8a - 5p Monday - Friday

About Texas Children's Hospital

Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.

To join our community of 14,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.

Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.


Summary:

We’re hunting for a Director of Business Operations, someone who’s ready to be part of the best ranked children’s hospital in Texas, and among the best in the nation. In this position, you will plan, organize, and direct the operations of the health plan. To provide leadership and oversight for health plan activities

related to Medicaid and CHIP and to ensure all are administered to ensure compliance with federal and state guidelines, along with other regulatory bodies that govern the operations of the hospital. Assist leaders with the development and implementation of policies and procedures related to the guidelines provided by the federal and state governments and other regulatory bodies.

Think you’ve got what it takes?

Job Duties & Responsibilities

  • Partners with TCHP department leaders to drive operations decisions regarding various functional areas of the health plan. Functional areas may include benefits management, enrollment, claims processing, and call center operations. Identifies key stakeholders and engages leaders in the decision-making processes. Ensures all decisions are documented and preserved for reference.  
  • Assists leaders with the development and implementation of policies, procedures, and guidelines to drive compliance with federal and state guidelines. Conducts periodic evaluation of operational processes to ensure compliance is maintained.  
  • Provides metrics and reports to monitor and track the status of operations. Works collaboratively with the appropriate groups to identify and prioritize opportunities for improvements. Leads cross-departmental teams to create and execute process improvement strategies that have an associated return on investment for the health plan. Tracks, monitors, and reports all process improvement outcomes to Sr. Leaders and employees.  
  • Works collaboratively with others, including IS, to ensure that the best possible systems are in place to drive excellence in the care delivery experience for TCHP members and providers across the continuum. Leads change to enhance the member and provider experience as needed. Assess the change's impact on operations and suggest modifications as warranted.  
  • Serves as a member and decision-maker of TCHP’s Medical Policy and Reimbursement Committees and provides guidance/input into the operational issues presented before these groups or others as appropriate.  
  • Collaborates with leaders and others within the Texas Children’s regarding cost of care initiatives and/or other strategies to be implemented across the system.

Skills & Requirements

  • Being fully vaccinated against COVID-19, including any booster dose(s) of the COVID-19 vaccine recommended by the Centers for Disease Control when eligible, is required for all employees unless approved for a medical or religious exemption.
  • Required bachelor's degree Healthcare Administration, Business Administration, or related field with a preferred master's degree Healthcare Administration, Business Administration, or related field
  • Preferred LSSC - Lean Six Sigma Certification
  • Required 8 years' experience in health plan operations, including four (4) years of management/leadership experience
  • Preferred experience in strategic planning and development and implementation of process improvement strategies across multiple areas 


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