Associate Director of Transportation Services at Partnership HealthPlan of California

Fairfield, California, United States -

Full Time

Start Date

Immediate

Expiry Date

29 Jan, 26

Salary

203763.0

Posted On

31 Oct, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Leadership Skills, Interpersonal Skills, Written Communication, Oral Communication, Customer Service Skills, Policy Development, Data Analysis, Quality Improvement, Training Development, Contract Negotiation, Regulatory Compliance, Claims Management, Performance Evaluation, Cost Containment, Collaboration, Problem Solving

Industry

Insurance

Description

Overview Under direction from the Director of Transportation Services, manages and provides direction to the Transportation Department Managers and Supervisors for NMT, NEMT and travel-related services. Plan, monitor and evaluate Transportation program activities to identify opportunities to enhance, improve and contribute to the positive health outcomes of our members in the most cost effective manner. Responsibilities Provides day-to-day direction to Transportation Managers and Supervisors to meet department goals and objectives. Responsible for ensuring performance evaluations are completed appropriately in a timely manner. Reviews Performance Evaluations prior to submission to the Director of Transportation. Coordinates activities with Member Services, Grievance, Care Coordination, Utilization Management, Claims, and Provider Relations departments to identify, track, and monitor quality of care issues and trends. Responsible for establishing and maintaining reports that will support the efficacy of each Transportation activity/program and to produce a summary at least annually or upon request that includes a summary of Transportation program activities, member outcomes, return on investment, and quality improvement activities. Provides oversight and monitoring of the claims, vendor invoices and grievances within Transportation to ensure timely response. Provides direction and oversight to ensure efficient and appropriate collaboration between the designated transportation platform provider, external transportation providers, transportation staff, and other impacted departments. Ensures that all policies and procedures are updated at least annually or as needed and presented to appropriate committees for review. Works with all other departments to resolve claims, UM, QI, and member issues as necessary. Reports any issues with regulatory compliance to Director of Transportation and assists in design and implementation of a corrective action plan when necessary. Participates in contract review and negotiation as appropriate Prepares reports on departmental activities according to established schedules and format. Identifies patterns and trends and works with Managers to develop corrective action plans. Works with Managers, Supervisors, and Trainer to develop standardized training content and material for new staff and for the ongoing education of existing staff. Provides oversight of training program to ensure adequate training accomplishes objectives and results in staff competency. Conducts retrospective review for quality, either in the aggregate or on an individual basis, as needed. Provides summaries of findings to the Director of Transportation. Assists staff and providers with the interpretation of Partnership policies, procedures, and regulatory requirements for transportation services. Promotes the continuous improvement process and implements recommended changes. Participates in all cost containment efforts of both the Health Services department and Partnership. Develops annual goals for individual performance and updates at least every six (6) months for progress. Works with other departments within Partnership to develop and implement improvements that will lead to improved performance or enhanced workflow of staff. Participates in the planning of new enhanced Health Services products. Participates in onsite audits by various regulatory agencies as necessary Serves as on-call transportation liaison to solve urgent calls that occur after normal business hours including holidays and weekends. Other duties as assigned Qualifications Education and Experience Bachelor’s degree in related field required and minimum five (5) years management experience preferably in a call center, transportation and/or managed care environment. Proficient in policy development. Develop data and analytical reports, track interventions, results, and report progress. Special Skills, Licenses and Certifications Knowledge of managed care operations preferred. Knowledge of Federal Medicaid or California Medi-Cal and Medicare programs. Valid California driver’s license and proof of current automobile insurance compliant with Partnership policy are required to operate a vehicle and travel for company business. Performance Based Competencies Demonstrated excellent leadership skills with ability to establish and motivate staff to achieve goals and objectives. Excellent interpersonal skills to ensure effective operations, meeting deadlines and standards. Excellent written and oral communication skills. Excellent customer service skills. Work Environment And Physical Demands Proficiency in MS Word, Excel, and PowerPoint preferred. More than 30% of work time is spent in front of a computer monitor. Ability to move about the department freely to assist with operational functions as needed. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan’s policies and procedures as they may from time to time be updated. HIRING RANGE: $156,741.30 - $203,763.69 IMPORTANT DISCLAIMER NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

Responsibilities

The Associate Director of Transportation Services manages the Transportation Department Managers and Supervisors, ensuring that program activities enhance health outcomes for members. This role includes oversight of claims, vendor invoices, and grievances, as well as collaboration with various departments to monitor quality of care issues.