FREE ACCESS
5,000–10,000 jobs/day
See all jobs on Scoutfield
Search thousands of fresh jobs every day.
Discover
- Fresh listings
- Fast filters
- No subscription required
Create a free account and start exploring right away.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates extensive experience in managing CG&A operations within the healthcare sector, focusing on compliance with CMS, NCQA, and State regulations. Proven ability to enhance operational efficiency, employee engagement, and customer satisfaction through strategic planning and effective training.
Highest-signal resume keywords
7+ Years Healthcare Management ExperienceLeadership ExperienceKnowledge of CMS and NCQA RegulationsExcellent Verbal and Written Communication SkillsAnalytical Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Operational EfficiencyRoot-Cause AnalysisBudget DevelopmentPerformance EvaluationPolicy DevelopmentWorkflow Efficiency ReportingTraining Material DevelopmentClient Audit ParticipationCorrective Action PlansData Analysis
Soft Skills
Interpersonal SkillsPresentation SkillsAttention to Detail
Tools & Technologies
ExcelMS WordOutlook
Industry Keywords
Healthcare ComplianceState Medicaid RegulationsCommercial RegulationsClinical TerminologyOperational Reporting
About the role
Key responsibilities & impact- Direct CG&A operations, training, and reporting functions
- Establish strategic direction and tactics to improve employee engagement, customer satisfaction, and operational efficiency
- Monitor daily and monthly turnaround times for compliance with client contracts
- Complete, communicate, and interpret monthly reporting requirements
- Develop action plans for gaps or potential deficiencies
- Ensure compliance with client expectations, contracts, State Laws/Regulations, CMS, and NCQA guidelines
- Develop and update department policies, procedures, and processes
- Develop and implement root-cause resolutions for operational and personnel issues
- Oversee training-material development and departmental training
- Identify, implement, quantify, and report workflow efficiencies
- Participate in client audits, including on-site and off-site audits
- Develop and maintain Corrective Action Plans and perform root-cause analysis
- Participate in business implementation projects as the CG&A Subject Matter Expert
- Build a data-based annual budget and establish efficiency-enhancing processes
- Manage CG&A staff performance, including performance and wage evaluations
- Participate in client presentations and implementations
- Adhere to business processes and perform other duties as needed
Requirements
What you’ll need- 7+ years’ experience managing in healthcare or related experience
- 7+ years of previous leadership experience
- Bachelor degree in related field or related experience required
- Ability to travel
- Knowledge of CMS and NCQA and State Medicaid/Commercial regulations or compliance requirements
- Excellent verbal and written communication skills with attention to detail
- Excellent analytical skills
- Previous experience presenting to high-level management and/or external constituents
- Excellent presentation and interpersonal skills
- Extensive knowledge of general computer software, including Excel, MS Word, and Outlook
- Knowledge of clinical and industry terminology and procedures preferred
- Ability to work in a fast-paced environment with multiple interruptions
- Ability to communicate in an active office environment
- Ability to efficiently operate job-related office equipment
- Ability to communicate via telephone
- Ability to sit for 80% or more of an 8-hour workday
- Ability to read and view computer screen
Benefits
Comp & perks- Generous vacation and sick time
- Paid family, parental and adoption leave
- Medical coverage
- Company paid life and AD&D insurance
- Disability programs
- Partially paid sabbatical program
- 401(k) employer match
- Stock purchase options
- Employer-funded retirement account
- Flexible, inclusive and collaborative work environment
- Career growth support
- Reasonable accommodations for qualified individuals with disabilities or special disabled veterans