Operations Manager (53428)

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.