Associate Director

Primary Job Role

Associate Director for ROS Operations

Job Responsibilities

1. Team Management

• Drive high levels of employee engagement through daily, weekly, and monthly team connects to enable high retention and satisfaction rates.
• Help manage team work-life balance through efforts on leave planning and rostering.
• Communicate effectively within the team and escalate issues to management for timely resolution.
• Continuously manage performance through timely and effective feedback and coaching.
• Partner with Recruiting and Training functions to help improve the quality of incoming talent.

2. Operations & Delivery

• Manage team production and conduct process quality monitoring.
• Allocate work assignments and review work lists.
• Encourage and engage team members in continuous improvement, process optimization, and automation ideas.
• Manage business intelligence through reports and MIS for internal and client use.
• Determine validity of move to client - either send back instruction to Rep or approve and move to client.
• Review coding requests and quantify preventable issues, communicating with Billing, PP, or Coding teams as applicable. Share findings with staff for examples of invalid coding reviews. Work with Coding on responses for appeals when coded correctly.
• Review denial adjustments for validity, quantify preventable issues, and communicate to applicable departments to minimize errors. Use accounts as examples in training for more effective actions.
• Review high-risk/aged/excessive incomplete action account balances.
• Manage review AR findings and provide feedback.
• Create QA and Tips for the week from client, payer, and account assessment scenarios.

3. Global Issues Management

• Review processes/functions managed for Global Issues, high-risk/aged items, payer trends, and training needs for team members.
• Create case studies on identified issues impacting team performance and client business, sharing inputs with Quality & Training teams.

4. Compliance

• Ensure adherence to the highest levels of organizational and healthcare-related compliance requirements.
• Ensure adherence to maintaining all necessary process documentation as per the Quality Management System (QMS).

Qualifications and Experience

• Graduation in any stream.
• Work experience of

  8+

  years with at least

  5+

  years in

  Pre-Auth

  function within a US Healthcare setup.
• Experience in managing teams of 20+ executives.
• Skilled in setting & measuring team targets, basic people management, and leadership.

Behavioral Competencies

• Ownership & Accountability
• Customer Focus
• Team Development
• Analytical Ability
• Achievement Orientation
• Planning

Functional Competencies

• Knowledge of the US Healthcare industry (mandatory).
• Basic knowledge of medical codes (preferred).
• Good feedback and coaching skills.
• Good interpersonal skills.
• Good communication skills.