Job Summary

The Assistant Operations Manager will report to the EBCI Tribal Option Operations Manager of the Cherokee Indian Hospital Authority (CIHA). The Assistant Operations Manager, under the leadership of the Tribal Option Operations Manager, and following a matrix team model, will help facilitate, as deemed appropriate, the overall management of the Tribal Option Operations plan, including participating in the development of the necessary infrastructure and reporting processes to meet the requirements set forth in accordance with the NC Department of Health and Human Services (NC DHHS).

Job Description

The position, as directed via the Operations Manager, is responsible for the following:  The position must work collaboratively across all departments to ensure awareness of the goals and expected outcomes and develop a process to continuously identify areas for study and improvement, as deemed appropriate. Additionally, the Assistant Operations Manager, under the leadership of the Operations Manager, recruits, hires, trains, and measures performance of staff. May be involved with the design, testing, and operations systems used to manage member data, performance data and produce reports related to program outcomes.

Essential Duties and Responsibilities

Administration, in collaboration with the Tribal Option Operations Manager:

• Ensures that the guiding vision, mission and values are incorporated into the development and operation of the Tribal Option.
• Provides direct supervision to Tribal Option Operations staff as assigned by the Tribal Option Operations Manager
• Provides leadership, supervision, and professional growth opportunities to direct reports.
• Develop and implement systems for gathering, managing and reporting Tribal Option data.
• Provides education to the community and key stakeholders on the mission and vision of the Tribal Option.
• Demonstrate knowledge of managed care and healthcare principles: legal, regulatory and confidentiality.
• Supports health plan management functions, develops, and maintains infrastructure and systems to monitor ongoing operational compliance with standards.
• Prepares and validates reports as required and requested.
• Ensures Tribal Option processes are executed in compliance with terms and conditions of DHHS Tribal Option PHP Contract.
• Examines processes and implements policies and procedures to continually improve upon the operation of the Tribal Option.
• Ensures appropriate monitoring and oversight of all functions delegated to outside entities.
• Assists CIHA/EBCI Tribal Option with various audit processes under the direction of the Tribal Option Operations Manager, in compliance with NCDHHS regulation.  
• Assists CIHA/EBCI Tribal Option with internal reviews of data, documentation, and process to ensure compliance with standards and regulation, under the direction of the Tribal Option Operations Manager.
• Ensures that the Tribal Option Operations Manager, Tribal Option Director and appropriate Tribal Option Manager(s) are informed of any identified concerns, issues, or insufficiencies in reports, dashboards, platform functionality, process, or policy that can impact compliance with NCDHHS standards or contractual agreement.
• On-going monitoring of dashboards, reports, and operational policy compliance.

Fiscal and Business Management

• Assists with the development of analytic reports to help manage operational risk, as deemed appropriate by the Operations Manager.
• Assist with development, monitoring, and producing reports that support the various areas of operations for Tribal Option
• Assist with validation and submission of reports supporting the operations of Tribal Option.
• Assist with policy and deliverable updates, reviews and the submission of these documents in compliance with contractual agreement(s).

Operational Functions:

• In collaboration with Tribal Option Managers and Tribal Option Director conducts annual evaluation of the operating plan, as deemed appropriate.
• Serves as a communication link and facilitator between CIHA departments, Tribal Option Managers, and Tribal Option resources and vendors.
• In collaboration with Tribal Option Managers, review technology tool (platform/dashboard) performance, process improvement, and assists to facilitate and/or implement action, as needed and deemed appropriate via the Operations Manager.
• Assists with facilitating, coordinating, and implementing Tribal Option technology update testing plans
• Reviews and assists with gap and needs assessment as needed and deemed appropriate via the Operations Manager.
• Ensures accuracy and timely submission of al reports, policies, deliverables, and documents outlined in the contract(s), as needed and deemed appropriate via the Operations Manager.
• Develops policies and procedures related to all aspects of Tribal Option operations, and management monitors compliance, reports trends and outcomes, as needed and deemed appropriate via the Operations Manager.
• Work cooperatively with internal staff as well as vendor staff, to effectively resolve technology platform issues and change request tickets, as deemed appropriate.
• Ensure sentinel events/incidents are reported to the state in accordance with state and federal law, as deemed appropriate via the Operations Manager.
• Create step-actions and train on various technology tools, and platforms, as deemed appropriate by the Operations Manager.

Education/Experience/Minimum Qualifications:

• A Bachelor’s degree in BS/BA required.  Health Care or Health Administration focused degree is preferred.
• Minimum five (5) years of recent health care operations or management, and two (2) years of managed care experience preferred.
• Experience with health care audits or chart audits preferred.
• Knowledge of Medicaid managed care and previous work with tribal health care preferred.
• Other requirements:
• Excellent verbal, written and interpersonal skills a must.
• Excellent analytical and organizational skills with strong attention to details.
• Proven ability to solve problems and make sound decisions.
• Ability to work collaboratively with patients, cross-functional agency units and departments.
• Ability to work independently and within a team environment.
• Ability to function effectively within an ever-changing environment to meet deadlines and reprioritize as necessary.
• Proficiency in MS Office, MS Teams, and Managed Care tools and platforms.

Supervision Received

The Assistant Operations Manager reports to the EBCI Tribal Option Operations Manager. The employee exercises a moderate degree of independence; may consult with the EBCI Tribal Option Operations Manager, Tribal Option Director, and other Tribal Option Managers in resolving issues and maintaining consistency and continuity across agency operations.

Contacts with Others

The primary personal contacts are with subordinates, co-workers, higher-ranking managers, CIHA Staff, leadership of outside entities, patients, and members of the community, as deemed appropriate via the Operations Manager. The purpose of the contacts is to coordinate contract(s) required activities and reviews, educate staff, providers or stakeholders on contract requirements and secure and exchange requested information

Customer Service

 Performs all work in a manner that reflects the mission, values and principles of the Right Way. Partners and coordinates with other departments to ensure total patient/customer satisfaction and efficient operations in a safe, friendly, comfortable environment, by well-trained, motivated employees. Recommends and implements change to improve overall patient/customer satisfaction. Performs all work in a manner that reflects the mission, values and principles of the Right Way.

Confidential Data 

Works with and/or has access to highly confidential files, memos, contract proposals, personnel and payroll information of which would be considered confidential and should not be disclosed. Must adhere to all CIHA confidentiality policies and procedures, as well as the Privacy Act of 1974 and HIPAA.

Responsibility for Accuracy 

Requires a high degree of accuracy. Work effects the accuracy and reliability of further processes, time schedules, staff time, and public relations. Most errors can be detected with proofing procedures. Errors may also have adverse effects on internal and outside relationships. Follows well define procedures and guidelines in job duties with minimal or no supervision. Must communicate and respond appropriately to various situations. Judgment and initiative are required to maintain accuracy, efficiency, and to prioritize work and meet deadlines.

Mental/Visual/Physical 

Expressing or exchanging ideas by means of spoken word. Talking is important for those activities in which oral information is communicated to the public, and in those activities in which they must convey detailed or important spoken instructions to others. Requires close concentration and attention to detail for sustained periods with potential interruptions. May involve problems of correlation or application of reports, statistics, or other data. Manual coordination may also be required. Subject to frequent interruptions requiring ability to maintain concentration and rendering of accurate responses. Work is performed with such physical requirements as walking, sitting, standing, reaching with arms and hands, bending, speaking, hearing, and visual acuity. 

Resourcefulness & Initiative 

This position must operate independently and have self-initiation while in a team environment.  The position must possess ability to exercise sound judgement when to seek supervision, escalate issues and when to make the decision.  The position must be proactive in monitoring and making recommendations to Tribal Option Operations Manager, and other Tribal Option Managers.

Environment 

Works in normal business office environment with occasional visits to program sites while performing job duties. 

Customer Service

Consistently demonstrates superior customer service skills to patients/customers by demonstrating characteristics that align with CIHA’s guiding principles and core values. Ensure excellent customer service is provided to all patients/customers by seeking out opportunities to be of service.