Salary Range $75,000.00 - $75,000.00 Salary/year
Position Type Full Time
Education Level 4 Year Degree
Description
POSITION SUMMARY:
The Operations Manager will oversee and manage fee for service substance abuse programming within Kentucky operations. The role involves comprehensive oversight of all substance abuse treatment programs, ensuring adherence to contractual obligations and fidelity to program standards. The ideal candidate will bring a deep understanding of substance abuse treatment methodologies, experience in program management, and a commitment to improving outcomes for individuals.
ESSENTIAL JOB FUNCTIONS:
Program Oversight: Manage all aspects of fee for service substance abuse treatment programs across multiple facilities in Kentucky.
Contract Compliance: Ensure strict adherence to contract terms and conditions with external service providers, monitoring performance and reporting compliance issues as necessary.
Quality Assurance: Monitor program fidelity to evidence-based practices and standards, implementing corrective actions as needed to maintain program integrity.
Data Analysis: Utilize data-driven insights to assess program effectiveness, identify areas for improvement, and prepare detailed reports for stakeholders.
Budget Management: Assist in the development and management of program budgets, ensuring resources are allocated efficiently and effectively.
Collaboration: Work collaboratively with correctional staff, healthcare providers, and external stakeholders to promote a holistic approach to substance abuse treatment and reentry support.
Claim Preparation & Submission: Prepare and submit accurate and timely medical claims to insurance companies, government programs, and other payers.
Charge Entry: Accurately enter charges into the billing system based on patient services and coding information.
Payment Posting: Post payments received from payers and patients to the appropriate accounts, ensuring accuracy in the allocation of funds.
Denial Management: Review and analyze claim denials, identify the reasons for denial, and take appropriate action to correct and resubmit claims.
Billing Audits: Perform regular audits of patient accounts to ensure accuracy in billing and coding, and identify any discrepancies or errors.
Compliance: Ensure all billing activities comply with federal, state, and local regulations, as well as internal policies and procedures.
Reporting: Assist in generating reports on billing activities, accounts receivable, write-off recommendations and other key metrics for review by the Revenue Cycle Manager.
Process Improvement: 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, clinical vision.
Perform all other duties as assigned.
Qualifications
ESSENTIAL QUALIFICATIONS:
To perform this job successfully, an individual must be able to perform the duties and responsibilities satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.
ESSENTIAL COMPETENCIES:
Passion: Commitment to improving outcomes for incarcerated individuals through effective substance abuse programming.
Ethics: Strong ethical standards and a commitment to upholding integrity in all aspects of program management.
Adaptability: Ability to thrive in a challenging and dynamic environment, demonstrating flexibility and resilience.
Communication: Excellent verbal and written communication skills, with the ability to convey complex information clearly and concisely.
Ability to understand a variety of models including cognitive behavioral therapy, theories of addiction and dynamics related to substance use and other criminogenic risk factors.
Knowledge of offender populations, criminal subcultures, and cultural differences, substance abuse assessment tools, therapeutic community concepts.
Ability to know and comply with program documentation requirements, applicable ethical and professional standards of conduct.
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During your tenure with WestCare there may be new requirements, including, but not limited to vaccinations that are issued by local, State, Federal, and/or Funders that WestCare may have to comply with. Should this occur Human Resources or appropriate personnel will inform you.
EDUCATION and/or EXPERIENCE:
Education: Bachelor's degree in Social Work, Psychology, Public Administration, Criminal Justice, or a related field. Master's degree preferred.
Experience: Minimum of 5 years of experience in program management, preferably in substance abuse treatment or correctional settings.
Knowledge: In-depth understanding of substance abuse treatment methodologies and evidence-based practices. Familiarity
Skills: Strong leadership and interpersonal skills. Ability to effectively manage teams and collaborate with diverse stakeholders. Excellent organizational and problem-solving abilities
WORKING CONDITIONS:
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Must be able to de-escalate situations in the program.
ESSENTIAL PHYSICAL AND MENTAL DEMANDS OF THE JOB:
The employee must be able to perform the following essential duties and activities with or without accommodation:
PHYSICAL DEMANDS:
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Requires mobility and physical activity: Having an adequate range of body motion and mobility to work in a correctional environment including standing and walking (even and uneven surfaces), sitting for extended periods of time, bending, twisting, reaching, balancing, occasional lifting and carrying of up to 10 pounds. Use of computer and telephone systems is required which includes coordination of eye and hand, and fine manipulation by the hands (typing, writing, and working with files). Requires the ability to defend oneself and clients in physically abusive situations using approved physical de-escalation techniques.
Requires talking: Expressing or exchanging ideas by means of the spoken word. Talking is required to impart oral information to employees, clients, patients, and the public, and in those activities in which the employee is required to convey detailed or important spoken instructions to others accurately, loudly, or quickly.
