Sr. Director, Operations - INTERNAL APPLICANTS ONLY - CAQH

Sr. Director, Operations - INTERNAL APPLICANTS ONLY

Post Date: Thursday December 12, 2024

Position: Sr. Director, Operations - INTERNAL APPLICANTS ONLY

Reports to: Chief Operating Officer

The Senior Director of Operations has overall responsibility for the business operations of a growing portfolio of nationwide industry products and services aimed at streamlining business processes across the healthcare system. This role defines the strategy, goals, and objectives for business process service operations for CAQH. This role is accountable for overseeing multiple teams delivering internal and vendor-operated service centers models. These service operations provide call center, document processing, data entry, fulfillment, technical interface, billing, training, and other production support functions to providers, health plans and other internal and external users of CAQH products and services. This role also oversees internal support services such as facilities management.

The Senior Director, Operations is a full-time, remote, exempt position and reports to the Chief Operating Officer.

Base Salary Range: $225,000 - $240,000 annually.

Specific Responsibilities:

1. Provide strategic leadership and hands-on oversight of internal and external operations to ensure optimal performance, efficiency, and quality.
2. Continuously evaluate and refine operational models to drive cost-effectiveness, maintain high-quality standards, and meet service level commitments.
3. Deliver multi-million in savings in 2025 and 2026 by modernizing a scalable customer support model.
4. Set clear goals and objectives for the operations function.
5. Partner with CAQH leadership to identify and prioritize operational requirements, align initiatives with organizational strategy, and manage change effectively.
6. Implement robust systems, tools, and processes to enhance monitoring, reporting, and decision-making across operational functions.
7. Develop demand and capacity forecasts to ensure operational readiness and scalability.
8. Act as the escalation point for operational issues, leading root cause analysis and driving corrective actions to resolution.
9. Systematically identify and execute opportunities for improvement, ensuring alignment with organizational objectives and cross-functional collaboration.
10. Foster a culture rooted in continuous improvement, user-centered design, and the ability to fail fast and learn quickly to drive innovation and operational excellence.
11. Oversee compliance with accreditation standards (e.g., NCQA) and regulatory requirements (e.g., HIPAA), maintaining operational integrity.
12. Manage multi-million-dollar budgets and vendor contracts, ensuring cost discipline and value realization.

Supervisory Responsibilities:

Position directs and supervises both internal (CAQH) and external leaders and staff. Responsible for designing and growing a successful support team through team member mentoring with a focus on career growth and succession planning.

Skills:

• Strong focus on customer service excellence and a positive user experience.
• Highly organized and efficient, with excellent follow-up skills.
• Strong and persuasive communication skills (written and verbal).
• Strong team building and personnel management capabilities.
• Ability to translate vision and goals into day-to-day activities and behaviors.
• Excellent abilities to direct and manage existing business processes while continuously looking for process improvement opportunities.
• Able to focus on details while still articulating the “big picture”.
• Ability to transform details and facts into recommendations and action plans.
• Ability to produce policy and process documentation.
• Ability to look at situations from several points of view.
• Analytical mindset with ability to creatively solve problems.
• Excels at operating in a fast pace and changing environment.
• Displays consistent professionalism and good judgment.
• Microsoft Office applications proficiency required and SalesForce experience a plus.
• Proficiency in the MS Office Suite (e.g., Word, Excel, Office 365 and PowerPoint)

Experience:

• A minimum of 10 years of experience in a healthcare setting, with emphasis on efficiency, identification and implementation of new capabilities to modernize customer service.
• A minimum of 10 years managing business operations and customer-facing support with a technology focus.
• A minimum of 10 years supervising operations management, staff and vendors.
• A minimum of 5 years in user-centered design experience required.
• Experience with designing, implementing, and managing in-house and outsourced solutions with multiple support models.

Education:

• B.A. or B.S. degree in Business Administration, Marketing, Communications, Healthcare Administration or a related field preferred.

Who We Are

Named one Modern Healthcare’s "Best Places to Work," CAQH has helped nearly 1,000 health plans, 2+ million providers, government entities and vendors connect, exchange information and operate more efficiently. CAQH technology-enabled solutions and its Committee on Operating Rules for Information Exchange (CORE) bring the healthcare industry together to make sharing business information more automated, predictable, and consistent. CAQH Insights researches opportunities to reduce the burden of manual processes in healthcare administration.

What You Get

CAQH recognizes that its most important asset is its growing team of smart, creative, collaborative, forward-thinking and passionate professionals – and that a comprehensive employee benefits package is an important factor for them in choosing where to work. CAQH offers competitive compensation along with an extensive benefits package for all full-time employees, including medical, dental and vision coverage, tuition assistance and a 401k. We offer full-time remote work to all staff from any location and maintain a physical office in downtown Washington, DC.

At CAQH, we are proud of our active commitment to Diversity, Equity, and Inclusion (DEI). Our DEI committee works diligently to foster an inclusive workplace where all individuals are valued, respected, and empowered. We embrace diverse perspectives and are dedicated to providing equal opportunities for everyone to thrive. Join us in our mission to transform healthcare through innovative technology solutions while making a positive impact on the lives of diverse communities.

CAQH is an equal opportunity employer. It is our policy to recruit, hire, train, and promote individuals, as well as administer any and all personnel actions, without regard to race, color, religion, sex, national origin or ancestry, age, marital status, disability, protected veteran status, personal appearance, sexual orientation, gender identity or expression, familial status, family responsibilities, matriculation, political affiliation, genetic information, source of income, place of residence, or any other characteristic protected by law. CAQH will not tolerate any unlawful discrimination and any such conduct is strictly prohibited.