Director, Care Services

Job Description:

The Director, Care Services is responsible for the administration of Ryan White and other special programs collectively known as Care Services. This encompasses the generation of sufficient revenues and professional operation of third-party payer services, proprietary department database (SCOUT) and technical services related to systems integration

• Provide leadership and direction in accordance with the goals and objectives of NextGen Healthcare/Managed Services.
• Establish strategy and tactics for achieving goals and objectives.
• Supervise program accounts receivable and accounts payable to manage P&L.
• Manage and delegate various program designs including provider networks, reimbursement rates, covered benefits and allowable expenses.
• Ensure proper technical support of SCOUT including database administration and custom report development.
• Perform other duties that support the overall objective of the position.

Education Required:

• Bachelor's Degree
• Or, any combination of education and experience which would provide the required qualifications for the position.

Experience Required:

• 10+ years of experience in a Healthcare/Managed Services client service related industry.
• Experience with database systems and basic SQL.

Knowledge, Skills & Abilities:

• Knowledge of: Ryan White programs including legislative guidelines encompassing HIV standards of care, payer of last resort structure, and allowable services. Banking procedures, including ACH processing. Claims adjudication processes, EDI workflows, and database systems. Business and management principles involved in strategic planning and coordination of people and resources. General accounting principles including cash and P & L management.
• Skill in: Time management, attention to detail, me and the time of others. Communicating effectively in writing as appropriate for the needs of the intended audience. Speaking in public, to groups, or via electronic media. Translating business needs of the department into technical requirements.
• Ability to: Completing assignments accurately and with attention to detail. Monitor/assess the performance of self, other individuals, or organizations to make improvements or take corrective action. Work well with cross departmental function leaders. Lead a diverse group of people. Handle difficult and stressful situations with professional composure. Effectively plan and delegate the work of others. Manage a budget and work within the constraints of that budget. Analyze, organize and prioritize work while meeting multiple deadlines.

The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is intended to provide guidelines for job expectations and the employee's ability to perform the position described. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate. This document does not represent a contract of employment, and the company reserves the right to change this job description and/or assign tasks for the employee to perform, as the company may deem appropriate.

NextGen Healthcare is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.