Kaiser Permanente/ The Southeast Permanente Medical Group

Business Operations Manager, Specialty Care

The Business Operations Manager, Specialty Services, under the direction of the Director of Specialty Services Operations in partnership with physician leaders and collaboration with health plan partners, provides operational leadership and business strategy support for the medical group’s specialty care departments. The position interfaces directly with department chiefs, physician administrative leaders as well as nursing management and other operational directors to ensure operational efficiency and high-level of performance.  Key focus areas of the role include: managing appointment access and provider allocations, financial analysis and claims data-mining, identifying and managing process improvement projects, building business cases and leading new service internalizations, and supporting chiefs with strategic insights and business management expertise for the optimal functioning of their practices.   

Management of Staff

The Business Operations Manager does not directly supervise staff. The role must apply a high-degree of influence to manage across functions such as MD/clinical, IT, finance, health plan operations, health informatics, and communications among other functions. 

Major Responsibilities/Essential Functions 

• Partners with specialty department chiefs and physician leaders to provide strategic direction and operations management expertise for sub-set of specialty  care departments (medical, procedural, surgical). Develops specialty care departments strategy plans and ensures execution of that plan according to  determined service, quality and financial efficiency metrics. Prepares performance monitoring tools including department scorecards to provide ongoing  oversight into key areas of business and clinical execution.

• Utilizing operations research, data analytics and performance monitoring tools, manages programmatic areas aligned to assigned specialty departments to  improve efficiency, quality and clinical outcomes. 

• Conducts utilization and external claims analysis and continuously monitors trends to ensure right care happens with right provider and right place of service.   When adverse trends are observed, rapidly performs root-cause analysis and presents findings and recommendations to chiefs and physician leaders for  remediation – leads execution of these plans.  

• Leverages data analytics and operational insights to guide provider distribution and appointment scheduling strategies. Advises department chiefs on optimal  allocation of subspecialists, practice locations, and procedural versus clinic time to enhance access and utilization.

• Seeks opportunities to reduce expenses and improve quality of care by internalizing medical and surgical services into the KP delivery system, to include  creation of required business cases 

Minimum Education

• BA/BS degree required

Preferred Education

• Master of Business Administration in marketing, strategy, health care administration and/or other related areas

Minimum Work Experience and Qualifications

• 3-5 years of healthcare experience
• Understanding of CPT and ICD9 coding and claims analysis
• Ability to work closely with physician leaders and use a consultative approach to make change within a highly matrixed organization
• Proven track record of achieving objectives through motivating and leading teams from a position of influence
• Ability to establish positive, professional relationships with senior leadership and management team members
• Excellent demonstrated use of quantitative reports and analysis
• Analytical skills utilizing Microsoft Office applications or similar applications in order to analyze large volumes of data.
• Proficient with the use of Excel, PowerPoint and Word.
• Excellent project management experience
• Training and experience in leading process improvement projects and change management
• Demonstrated organizational and problem-solving skills, as well as strategic and systems thinking capability
• Demonstrate proven track record of managing multiple complex projects simultaneously

Preferred Work Experience and Qualification

• Thorough understanding of the insurance industry and HMO regulations, including State and Federal laws.
• Work experience in large multi-specialty medical group business practices.
• Certification in Process Improvement