Strategic Director, Managed Care Operations

Desert Oasis Healthcare; Palm Springs (CA); Hybrid; USD 180,000 - 240,000; Full time

Job summary

Desert Oasis Healthcare is seeking a Director of Managed Care Operations in California to lead the Financial Operations division and optimize revenue and efficiency across Claims, Billing, Eligibility, and Contracting.

You will collaborate with executives to implement long-term financial strategies, oversee informatics and reporting systems, and drive organizational transformation in a hybrid work model.

Qualifications

• Bachelor's degree required.
• 10 years of claims management experience and 2 years of supervisory experience required.
• Knowledge of Medicare and DMHC regulations, medical terminology, managed care health plan rules and regulations, ICD-9, CPT and RVs codes.
• Strong organizational skills and ability to work independently and under pressure.
• Proficiency with Word, Excel, Outlook, PowerPoint and other software/applications.
• Valid California driver's license and proof of insurance.
• Position may be full- or hybrid-telecommuting at DOHC/FHC management discretion.

Responsibilities

• Provide strategic leadership to the Financial Operations division including Claims, Billing, Eligibility, Benefits, Materials Management, Business Informatics and Contracting.
• Foster accountability, transparency, operational excellence, and governance across Finance with robust performance management.
• Co-develop and execute short- and long-term efficiency and financial strategies under CFO supervision.
• Prepare high-quality executive communications translating complex topics into concise actions.
• Serve as the Designated Principal Officer for monthly timeliness reports to Health Plans and corporate offices.
• Engineer processes to maximize efficiency and customer service while resolving deficiencies.
• Identify, recruit and retain talent to lead key departments and MSO functions.
• Oversee business informatics infrastructure supporting daily operations and EDI, including EMR, scheduling, and reporting tools.
• Build partnerships across units to improve decision making and leverage capabilities.
• Monitor regulatory and financial trends affecting strategy and performance.
• Support CFO in prioritization, governance, and executive decisions.
• Perform other duties as assigned.

Skills

Strategic leadership

Mentorship

Governance

Performance management

Communication

Education

Bachelor's degree

Tools

Microsoft Office

Job description

Desert Oasis Healthcare is seeking a Director of Managed Care Operations in California to lead the Financial Operations division and optimize revenue and efficiency across Claims, Billing, Eligibility, and Contracting.

You will collaborate with executives to implement long-term financial strategies, oversee informatics and reporting systems, and drive organizational transformation in a hybrid work model.