Notice of Collection & Privacy Policy for Applicants Residing in California:

Manager Operations

The Operations Manager provides guidance, leadership, planning, and reporting to the assigned business unit. This position ensures the assigned business unit is administering the organizations contracts with the best possible service while maintaining contract expectations and within budget constraints and optimizing staffing levels.

• Coaches and develops staff by encouraging growth and ensuring staff are meeting performance expectations
• Ensures the organization meets all contractual expectations
• Manages budgets and works to meet requirements with available funding
• Ensures responsiveness to audit findings and implements timely changes as appropriate
• Ensures strong internal controls and compliance programs within responsible operations
• Initiates process improvements and technology implementation
• Initiates disciplinary action when performance does not meet expectations
• Leads by example by promoting teamwork, recognition, and leadership while demonstrating the company values
• May provide guidance on evaluating the circumstances of cases related to suspected fraud to support potential investigations and fraud prevention procedures
• Assist in organizational and corporate growth opportunities
• Responds to and implements changes in a flexible, positive manner
• Participates as the area subject-matter expert during business development activities as needed

• Other duties as assigned

• Bachelor's degree in Business Administration, Management, or closely related field or equivalent work experience as determined by HR
• 4 years' experience managing staff
• Knowledge of management theories and practices
• Understands computer information systems
• Knowledge of basic accounting practices
• Specific contracts may require: Bachelor's degree in Business Administration, Management or closely related field and 10 years' management experience
• Specific contracts may require: Compliance, Investigation and Fraud Prevention experience required. Certified Fraud Examiner (CFE) or Accredited Healthcare Fraud Investigator (AHFI) required.
• Specific contracts may require: Experience required in Medicare Hearings & Appeals. Be familiar with all current policies and regulations. 42 CFR 498 and PIM.
• Specific contracts may require: 10+ years of professional experience with 3 years managing complex system and workflow. Requires master's degree or additional 4-year equivalent experience as determined by the HR.
• IME Key Personnel requires: 4 years' experience managing claims processing operations and personnel for a Medicaid state entity, fiscal agent, or private sector health care payor, including a minimum of two years MMIS experience
• MAC A/B PE Key Personnel requires: Bachelor's degree and 3 years' experience with Medicare Fee-for-Service provider enrollment operations and 5 years of supervisory/team lead experience for Medicare Part A or Part B operations. Bachelor's degree may be substituted with 10 years' experience with Medicare Part A or B operations.
• MAC A/B Claims Key Personnel Requirements: 3 years work experience with Medicare or Medicare-equivalent Fee-for-Service claims processing operations. Prior experience with both Medicare Part A and Part B claims processing operations is required

• Bachelor's degree in Business Administration or Management
• 5 years' experience managing staff
• Strong written and oral communication skills
• Ability to motivate and manage a large group of people
• Ability to direct and maintain a productive and conducive working environment
• Ability to coordinate activities among co-workers
• Ability to develop problem solving skills within staff
• Strong analytical skills

• Office Environment
• Ability to read, hear, speak, keyboard, reason, communicate effectively and problem solve
• Requires prolonged sitting and telephone use
• Requires the use of office equipment such as computer terminals, telephones, copiers, and printers
• Infrequent lifting to 15 pounds
• Infrequent stooping

Every employee is responsible to perform their duties and responsibilities in accordance with Noridian values, policies and procedures, including but not limited to: Segregation of Duties Principles, HIPAA, Security and Privacy, CMS requirements, the Noridian Compliance Program and any other applicable laws, rules and regulations.

This document describes the essential functions, requirements, and responsibilities of this job, and is not intended to be a complete list of all tasks and functions. Employees may be requested to perform job related tasks other than those specifically listed in this description and may be required to perform any task requested by the supervisor or management.

Health, Dental and Vision Insurance, Voluntary Insurance Plans, Health Savings and Flexible Spending Accounts, 401k and Company Match, Company-paid Life Insurance, Education Assistance Program, Paid Sick Leave, Paid Holidays, Increasing PTO Accrual Plan, Medical/Parental/Disability Leave, Workers Compensation, Retiree Benefits, Severance Package, Employee Assistance Program, Financial and Health Wellness Benefits, Casual Dress, Open Office Setting, and Online Learning System.

Some positions require compliance with (i) federal and agency specific regulations and related clauses included in Noridian's prime contracts with the Government, (ii) background checks, and (iii) eligibility for a government-issued identification card.

Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities as well as Sexual Orientation or Gender Identity.

Below is the salary range for potential new hires.

Salary Range: $68,928.86 - $113,369.53

Other Compensation: Self-Managed PTO (if applicable), Incentive Plan

Lifestyle Benefit: $50/month

This job will be closed 04/25/2024 at 8:00AM CST. No further applications will be considered.