Title: Sr Operations Manager
Location: San Diego, CA
SCOPE
Participates in the development and execution of overall Medicare Operations objectives and KP goals. Responsible for maintaining an efficient & effective operation for the administration of Medicare enrollment, disenrollment, and reconciliation for all 8 KP regions which is in compliance with CMS and other appropriate regulations.
Will work closely with Compliance, Medicare Administrative Programs, and Regional Membership Administration Liaisons in accomplishing goals.
Drives change, process improvements & cultural transformation of Medicare Operations and acts as change leader.
Encourages management development by providing opportunities for leadership and working with other leaders throughout Membership Administration and Customer Service & Program Management (CS&PM).
MANAGEMENT OF STAFF
Provides managerial responsibility and support for three sub-functions (Enrollment/Disenrollment; Reconciliation; Customer Service) within Medicare Operations, directly and through subordinates, as appropriate.
Accomplishes results directly, and through subordinates, who exercise significant latitude and independence in their assignments.
Develops performance requirements.
Determines and establishes organizational structures.
May have budget responsibilities.
PROBLEM SOLVING
Works on complex issues where analysis of situations or data requires an in-depth knowledge of organizational objectives and functional trends.
Requires experienced business or technical judgment to create novel solutions for thought-provoking, diverse and highly complex issues.
Analyzes recommendations made by others to solve issues bearing broad or company-wide impact.
May involve the application of sophisticated methodology.
DECISION-MAKING
Involves a high degree of interpretation and analysis of obscure or inconclusive data.
Has final authority to make most decisions, except for those that require additional management approval.
Requires a broad range of highly complex decision-making.
Some decisions could be precedent setting.
Uses understanding of the vision for KP to ensure that all actions taken within the regions are aligned.
INDEPENDENCE / DISCRETION
Exercises considerable latitude in determining objectives and approaches to assignments.
Management reviews results to determine success of operation.
INTERACTIONS / COMMUNICATIONS
Regularly interacts with senior managers, regions, and/or business partners concerning Medicare Operations.
Interactions normally involve difficult situations, negotiations, or influencing other senior management.
Requires the ability to change the thinking of, or gain the acceptance of, others in difficult matters.
Discusses and presents information and issues internally and externally and potentially controversial issues within CS&PM and KP.
Qualifications:
Basic Qualifications:
- Requires minimum eight (8) years supervisory or management experience in a Member Services, Health care or Customer Service Call Center field, including three (3) to five (5) years management experience involving high level negotiations.
- Experience in managing large groups of employees in a collaborative work team environment required.
- Labor-Management Partnership environment experience.
- Four (4) year degree in business administration, health care, or related field or equivalent experience required. The equivalent experience must be additional experience beyond the minimum work experience required above.
- Requires advanced knowledge of call centers and working knowledge of multiple related functions.
- Knowledge of Call Center telephony that includes queuing theories, workforce scheduling and telecommunications.
- Strong interpersonal and communication skills; excellent written and verbal skills.
- Ability to set goals and objectives, reaching them in prescribed timeframes.
- Must be able to act as a change agent.
- Ability to create strategy and tactical approaches to address operational issues.
- Must be able to act quickly in a crisis.
