Location: Wausau,WI, USA
Compassion. Accountability. Collaboration. Foresight. Joy.
These are the Aspirus Core Values; and we are looking for the BEST around to join us as we demonstrate those values Every. Single. Day.
Aspirus Health in Wausau, WI is seeking a DIRECTOR- OPERATIONS ASPIRUS HEALTH PLAN to join the team!
The Director of Operations position is responsible of complete health plan operational delivery of commercial (Small, Large), ACA, ACO, and Medicare with associated KPIs goals for optimal plan MLR and Admin performance. The person will oversee and action gaps to ensure comprehensive operational delivery (Call Center, claims processing, FWA - recovery, KPIs, HCIs, enrollment, Network, Reporting, Service levels, BCP) and align with Finance, clinical, Marketing daily. Be the liaison and is responsible for the operational delivery for commercial and Medicare Advantage via Third Party Administrators, and Pharmacy Benefit Managers to ensure accuracy and efficiencies with all Aspirus Health Plan functional areas.
HOURS: Full time, 1.0 FTE
Experience/Qualifications
* Bachelor's degree
* Experience with Medicare Advantage Insurance operations preferred.
* Possesses a valid driver's license required to travel as needed between Madison and Wausau.
* Extensive Health Plan Operations Experience
* Extensive Network Contracting negotiation skills
* AT least (4) claim platform migrations
* New Health Plan startup experience
* Ability to maintain, update, and oversee a customer relationship management system
* Microsoft Power BI, Access, Outlook, SharePoint, and Visio
Employee Benefits
* Full benefits packages available for part- and full-time status.
* PTO accrual from day one!
* Generous retirement plan with match available.
* Wellness program for employees and their families.
Aspirus Wausau Hospital is the flagship of the Aspirus system that serves patients in 14 counties across northern and central Wisconsin, as well as the Upper Peninsula of Michigan. It is a licensed private/not-for-profit facility with 325 beds and staffed by 350 physicians in 35 specialties. Aspirus Wausau Hospital is a Level II trauma center that provides primary, secondary and tertiary care services as a regional referral center. Specialty referral service emphasis exists in cardiology and cardiothoracic surgery, orthopedics and cancer. The hospital has an average daily inpatient census of 220 with approximately 15,000 admissions per year. Outpatient visits exceed 50,000 and there are also more than 24,000 annual emergency department visits. To learn more about Wausau click the following link: Wausau, Wisconsin
Best known for its world-class cardiovascular program, Aspirus Wausau Hospital also provides leading edge cancer, trauma, women's health, and spine and neurological care.
Our Mission: We heal people, promote health and strengthen communities.
Our Vision: Aspirus is a catalyst for creating healthy, thriving communities, trusted and engaged above all others.
As an Aspirus team, we demonstrate caring, we plan to impact the future, work with happiness and enthusiasm, recognize our power to make a difference and improve the health of our communities.
Aspirus Health is a nonprofit, community-directed health system based in Wausau, Wisconsin, serving northeastern Minnesota, northern and central Wisconsin and the Upper Peninsula of Michigan. The health system operates 19 hospitals and 130 outpatient locations with nearly 14,000 team members, including 1,300 employed physicians and advanced practice clinicians. For more information visit aspirus.org.
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