Director, Insurance Management

POSITION SUMMARY:

The Director, Insurance Management is responsible for overseeing teams that manage coverage verification and insurance authorization. This role provides leadership and direction to teams that engage with key stakeholders, including parents and families, speech-language pathologists, and payer representatives, to ensure that the QuickTalker Freestyle is made available to insurance-approved recipients in an efficient and compliant manner. The Director is also accountable for ensuring a high standard of accuracy and for driving continuous process improvement across these teams. In addition, this role supports the development and engagement of leadership-level staff by applying strong listening, learning, and leadership practices to achieve optimal outcomes that appropriately balance customer needs with organizational responsibilities.

POSITION RESPONSIBILITIES: 

1. Lead the development and delivery of strategic plans for the coverage verification and insurance management teams operational workflows.
2. Create strategies and measurables for the staff responsible for delivering coverage verification and insurance management.
3. Deliver on the key performance indicators (KPIs) that measure the success of coverage verification and insurance management as defined by senior leadership.
4. Analyze requests to identify trends, assess process gaps, and recommend strategic improvements and decision-making with a focus on increased efficiency and accuracy.
5. Oversee the compliance of all evaluation teams with HIPAA, FRPA, and all other relevant regulatory standards.
6. Foster a collaborative, innovative work environment that encourages teamwork.
7. Participate in cross-functional collaboration with marketing, business development, business systems and other funding-focused departments to align funding strategies with overall business objectives.
8. Consistently demonstrate and advocate for the Listen, Learn and Lead philosophy of the medical funding department, as well as the AbleNet Guiding Principles and 7 Rules of Engagement.
9. All other duties as assigned.

CORE COMPETENCIES, SKILLS & ABILITIES: 

1. Strong understanding of healthcare medical policies, insurance processes, and regulatory requirements.
2. Excellent leadership and team management skills.
3. Analytical mindset with the ability to interpret and leverage data in executing on business strategy.
4. Proven cross-functional collaboration with a focus on continuous improvement and best outcomes.
5. Computer literacy and demonstrated ability to learn and adapt new technology into daily processes.
6. Ability to work effectively while multi-tasking and under pressure.

POSITION REQUIREMENTS:

Education & Experience

• Bachelor’s degree required
• 5+ years of experience in people-leadership roles
• 5+ years’ experience executing decisions in support of strategic philosophies 
• 5+ years of experience with focus in workflows and process improvement

Physical, Time, Presence & Other Requirements

 Internal Office Environment – Requires regular sitting or standing at a desk, consistent computer keyboarding and mouse use, and the ability to perform routine office tasks in a professional office setting.

 Full-Time, exempt employees work an average of 40 hours per week. Additional hours may be required as necessary.

 Fully Remote - onsite presence is not expected/will be minimal

Occasional (10%) - potential for travel 1-2 times quarterly for onsite visits and trainings