About this role
Position Summary:
The Operations Manager will oversee and manage fee for service substance abuse programming within Tennessee operations. The role involves comprehensive oversight of all substance abuse treatment program, ensuring adherence to contractual obligations and fidelity to program standards.
Essential Job Functions:
- Manage all aspects of fee for service substance abuse treatment programs across multiple facilities in Tennessee.
- Ensure strict adherence to contract terms and conditions with external service providers, monitoring performance and reporting compliance issues as necessary.
- Monitor program fidelity to evidence-based practices and standards, implementing corrective actions as needed to maintain program integrity.
- Utilize data-driven insights to assess program effectiveness, identify areas for improvement, and prepare detailed reports for stakeholders.
- Assist in the development and management of program budgets, ensuring resources are allocated efficiently and effectively.
- Work collaboratively with correctional staff, healthcare providers, and external stakeholders to promote a holistic approach to substance abuse treatment and reentry support.
- Prepare and submit accurate and timely medical claims to insurance companies, government programs, and other payers.
- Accurately enter charges into the billing system based on patient services and coding information.
- Post payments received from payers and patients to the appropriate accounts, ensuring accuracy in the allocation of funds.
- Review and analyze claim denials, identify the reasons for denial, and take appropriate action to correct and resubmit claims.
- Perform regular audits of patient accounts to ensure accuracy in billing and coding, and identify any discrepancies or errors.
- Ensure all billing activities comply with federal, state, and local regulations, as well as internal policies and procedures.
- Assist in generating reports on billing activities, accounts receivable, write-off recommendations and other key metrics for review by the Revenue Cycle Manager.
- Identify opportunities to streamline billing processes and improve efficiency, making recommendations to the Revenue Cycle Manager.
- Must embrace and embody the mission, vision, guiding principles, and clinical vision.
- Perform all other duties as assigned.
Qualifications
Essential Qualifications:
Certifications/Licensures:
- Valid driver’s license and the ability to obtain and maintain WestCare’s vehicle insurance
is required.
Education:
- Bachelor's degree in Social Work, Psychology, Public Administration, Criminal Justice, or a related field is preferred.
- High school diploma or equivalent is required.
Experience and Competencies:
- Minimum of 5 years of experience in program management, preferably in substance abuse treatment or correctional settings.
- In-depth understanding of substance abuse treatment methodologies and evidence-based practices. Familiarity with relevant regulations and program requirements.
- Strong leadership and interpersonal skills. Ability to effectively manage teams and collaborate with diverse stakeholders. Excellent organizational and problem-solving abilities.
- Commitment to improving outcomes for incarcerated individuals through effective substance abuse programming.
- Strong ethical standards and a commitment to upholding integrity in all aspects of program management.
- Ability to thrive in a challenging and dynamic environment, demonstrating flexibility and resilience.
- Excellent verbal and written communication skills, with the ability to convey complex information clearly and concisely.
- Ability to understand a variety of models, including cognitive behavioral therapy, theories of addiction, and dynamics related to substance use and other criminogenic risk factors.
- Knowledge of offender populations, criminal subcultures, cultural differences, substance abuse assessment tools, and therapeutic community concepts.
- Ability to know and comply with program documentation requirements and applicable ethical and professional standards of conduct.
Working Conditions:
- Work is primarily performed in an office or other indoor setting;
- Extensive outdoor activities and travel will be required;
- Regular and prompt attendance is required throughout employment.
Essential Physical and Mental Demands of the Job
- The employee must be able to perform the following essential duties and activities with or without accommodation:
Physical Demands:
- Requires mobility and physical activity: Having an adequate range of body motion and mobility to work in an office, residential, or outdoor environment including standing and walking (even and uneven surfaces), sitting for extended periods of time, bending, twisting, reaching, balancing, occasional lifting and carrying of up to 50 pounds. Use of computer and telephone systems is required which includes coordination of eye and hand, and fine manipulation by the hands (typing, writing, and working with files). Requires the ability to defend oneself and clients in physically abusive situations through the use of approved physical de-escalation techniques.
- Requires talking: Expressing or exchanging ideas by means of the spoken word. Talking is required to impart oral information to employees, clients, patients, and the public, and in those activities in which the employee is required to convey detailed or important spoken instructions to others accurately, loudly, or quickly.
- Requires hearing: Hearing is required to receive and communicate detailed information through oral communication.
- Requires seeing: Clarity of vision at 20 inches or less and at distance. This factor is required to complete paperwork for many of the employee’s essential job functions and to observe client behavior and activities in and out of the facility.
- The normal work routine involves no exposure to human blood, body fluids or tissues. However, exposure or potential exposure may be required as a condition of employment. Appropriate personal protective equipment will be readily available to every employee. Mental Demands:
- Requires the ability to collect and analyze complex numerical and written data and verbal information to reach logical conclusions.
- Requires the ability to work and cooperate with clients, co-workers, managers, the public and employees at all levels in order to exchange ideas, information, instructions and opinions.
- Requires the ability to work under stress and in emotionally charged settings.