Claritev is an Equal Opportunity Employer and complies with all applicable laws and regulations. Qualified applicants will receive consideration for employment without regard to age, race, color, religion, gender, sexual orientation, gender identity, national origin, disability or protected veteran status.
Director of Dispute Resolution
Location
United States
Posted
7 hours ago
Salary
$140K - $160K / year
Seniority
Lead
No structured requirement data.
Job Description
Director of Dispute Resolution
Claritev
Role Description This position is responsible for the oversight and direction of the Arbitration solution. Responsibilities include: - Providing leadership and decision-making to ensure high-quality service is provided to account management, clients, providers, IDR entities, CMS client's internal customers, and vendor relationships. - Managing or overseeing all activities with associated units, including developing and implementing policies and procedures on all related systems and workflows. - Achieving short and long-range business goals and ensuring operating efficiency. - Directing all facets of the department including staffing, goal setting, budget compliance, product evaluation, and enhancement. - Coordinating communication and activities between Operations, Sales and Marketing, Human Resources, Network Development, Quality Assurance, IT, and Legal departments. Qualifications - Bachelor Degree or minimum 5 years’ experience in the healthcare industry with 2 years in a leadership role with people management responsibilities. - Required licensures, professional certifications, and/or Board certifications as applicable. - Excellent organizational, analytical, and independent decision-making skills. - Demonstrated problem-solving skills with the ability to manage multiple priorities and meet associated timelines. - Knowledge of provider billing and collection practices. - Knowledge of effective negotiation principles. - Knowledge of commonly used medical data resources. - Strong communication (verbal and written), managerial, interpersonal, organizational, time management, customer service/sales, problem-solving, leadership, strategic, analytical, tactical, and execution skills. - Ability to prioritize and manage time effectively. - Ability to make decisions using limited or incomplete data. - Advanced proficiency with MS Office and ability to use software, hardware, and peripherals related to job responsibilities. Requirements - Direct management of performance to ensure competent staff delivers quality results, including training, mentoring, motivating, and overseeing staff performance. - Develop, implement, and manage both short- and long-term goals, objectives, policies, and procedures based on current and future trends and legislative requirements. - Compile, analyze, and report on trends to include performance improvement initiatives and exceptional client delivery. - Oversight and development of operational relationships and performance for clients, account management, and other stakeholders. - Identify opportunities for performance improvement and operational efficiencies. - Manage departmental and team budgets including expenses, cost containment, and profitability. - Provide direction and guidance to other levels of management, through delivery of instructions and direction to staff on individual cases. - Act as a subject matter expert internally for the Team and other departments within the Company. - Select, develop, and evaluate staff to ensure the efficient operation of the department. - Collaborate, coordinate, and communicate across disciplines and departments. - Ensure compliance with HIPAA regulations and requirements. - Demonstrate Company's Core Competencies and values held within. - Perform weekly Soft Audits on cases worked by team members and address performance issues. Benefits - Medical, dental, and vision coverage with low deductible & copay. - Life insurance. - Short and long-term disability. - Paid Parental Leave. - 401(k) + match. - Employee Stock Purchase Plan. - Generous Paid Time Off – accrued based on years of service. - 10 paid company holidays. - Tuition reimbursement. - Flexible Spending Account. - Employee Assistance Program. - Sick time benefits – for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year.
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