Director of Operations (Prospective Risk Adjustment / Interoperability and Clinical Improvement)
Reveleer
Reveleer is a healthcare data and analytics company that uses Artificial Intelligence to give health plans across all business lines greater control over their Quality Improvement, Risk Adjustment, and Member Management programs.
With one transformative solution, the Reveleer platform enables plans to independently execute and manage every aspect of enrollment, provider outreach and data retrieval, coding, abstraction, reporting, and submissions.
Leveraging proprietary technology, robust data sets, and subject matter expertise, Reveleer provides complete record retrieval and review services so health plans can confidently plan and execute risk, quality, and member management programs to deliver more value and improved outcomes.
The Director of Operations will oversee the strategic planning and execution of operations with a focus on risk adjustment, interoperability, and clinical improvement.
This role will ensure that our operations align with regulatory requirements, industry best practices, and organizational goals for Reveleer and its Customers.
The Director of Operations will also drive the development of strategies to improve clinical improvement, risk adjustment processes and enhance interoperability within our products and customer’s systems.
Responsibilities :
- Lead and oversee the operational strategies for clinical improvement, prospective risk adjustment and interoperability, while ensuring compliance with healthcare regulations and industry standards.
- Develop and implement processes to enhance the clinical improvement and prospective risk adjustment accuracy and efficiency.
- Drive the development and execution of interoperability initiatives to improve data sharing and integration across Reveleer products and healthcare systems, including but not limited to Electronic Health Record (EHR), Point of Care applications, Population Health, Care Coordination, Care Management and Data Analytics systems.
- Collaborate with cross-functional teams to identify and address operational challenges and opportunities for improvement.
- Manage the day-to-day operations, including overseeing staff, managing budgets, and ensuring operational efficiency.
- Build and maintain strong relationships with key stakeholders, including healthcare providers, vendors, and regulatory bodies.
- Monitor and analyze operational performance metrics, identifying areas for improvement and implementing corrective actions as needed.
- Ensure the delivery of high-quality services and products that meet or exceed customer and regulatory expectations.
- Lead efforts to innovate and improve Reveleer products, operational processes while leveraging technology and industry best practices.
Qualifications :
- Bachelor's degree in Healthcare Administration, Business Administration, Operations Management, or a related field. Advanced degree preferred.
- Extensive experience in healthcare operations, with a focus on Value Based Care, Risk Adjustment and Interoperability.
- Strong understanding of healthcare regulations, risk adjustment methodologies, and interoperability standards.
- Proven track record of successfully leading and managing operational teams.
- Excellent strategic planning and project management skills.
- Strong analytical and problem-solving abilities.
- Exceptional communication and interpersonal skills, with the ability to build and maintain relationships with diverse stakeholders.
- Proficiency in using healthcare management software and tools.
Skills :
- Leadership and team management.
- Strategic planning and execution.
- Operational efficiency and process improvement.
- Risk adjustment and regulatory compliance.
- Healthcare Interoperability and data integration.
- Budget management and financial acumen.
- Communication and relationship-building.
Why Join Us :
- Opportunity to lead and innovate in a dynamic and growing technology organization focused on Value Base Care.
- Competitive salary and comprehensive benefits package.
- Professional development and career advancement opportunities.
- A collaborative and supportive work environment dedicated to improving healthcare outcomes.
What You’ll Receive :
- Competitive salary
- Medical, Dental and Vision benefits
- 401k with Employer Match
- Generous PTO plan
Salary Range : $130,000 - $150,000 / annually
Our compensation reflects the cost of labor across several US geographic markets. Pay is based on several factors including market location and may vary depending on job-related knowledge, skills, and experience.
Reveleer E-Verifies all new hires.
Reveleer is an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, gender identity, sexual orientation, age, marital status, veteran status, disability status or genetic information, in compliance with applicable federal, state and local law.
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