Dane Street

Operations

• 100% REMOTE
• JOB SUMMARY
• Oversee and ensure the overall profitability of the regional operations center. This includes but is not limited to reaching and exceeding financial & referral goals, properly managing staffing efficiencies throughout the team, managing performance expectations & improvements for existing staff. Present management with regular reporting on any topic requested by the management team.
• Dane Street’s success relies on individual and team contributions every day. We care for our customers, each other and Dane Street. It is the responsibility for all of us to maintain a positive working environment that promotes client satisfaction and results.
• MAJOR DUTIES & RESPONSIBILITIES
• Driving Revenue Growth
• The Operations Manager drives revenue growth by delivering excellent Customer service.
• This includes meeting scheduling best practices and turnaround time requirements.
• Ensuring the timely delivery of high quality reports.
• Managing client inquiries in a timely manner.
• Optimizing Physician cost
• Ensuring that client invoices adhere to the agreed upon fee schedule.
• Overseeing the proper selection of physicians.
• Specifically ensuring that the team selects the most appropriate physician based on the claimant’s location, the required specialty, and the most appropriately priced physician based on the client’s fee schedule.
• Building relationships with key physicians to ensure panel retention.
• Manage Staff Performance and capacity
• Monitor key performance metrics of individual Customer Service Representatives (CSR) and Quality Assurance (QA) Specialists.
• Ensure the team meets or exceeds 85% of output goals for scheduling and Quality Assurance targets.
• Responsible for hiring new staff members based on increased referral volume and/or the addition of new clients.
• Conducts performance evaluations that are timely and constructive.
• Handles discipline and termination of employees as needed and in accordance with company policy.
• Responsible for the overall production, performance, and quality of the assigned region.
• Plans and organizes daily activities related to production and operations.
• Measures productivity by analyzing performance data, financial data, and activity reports.
• Coordinates with other support departments such as human resources, finance, and IT and BA to ensure successful production operations.
• Determines labor needs to meet production goals.

Group Health Operations Manager, RN/LPN

Recruitment

• Job Summary: The Phyisican Recruiter is responsible for maintaining and expanding Dane Street’s physician panel. This includes negotiating physician fees within pre-established guidelines, onboarding new physicians based on client demand, and ensuring that all open service requests (OSRs) are resolved promptly. The ideal candidate will leverage existing relationships and industry knowledge to strategically grow the network and support business operations.
• Panel Maintenance & Growth: Understand client fee schedules and turnaround time (TAT) requirements to negotiate physician agreement terms.
• Panel Maintenance & Growth: Conduct outreach for refunds or recoupments; collaborate with Finance and Legal when collections are required.
• Panel Maintenance & Growth: Maintain existing physician records, including: Fee updates; W9 and remittance changes; Profile instructions; Doctor groups; Deactivations/reactivations.
• Panel Maintenance & Growth: Research and source new panel options as needed.
• Panel Maintenance & Growth: Onboard new physicians based on client needs.
• Panel Maintenance & Growth: Negotiate rates and contract terms per company guidelines.
• Panel Maintenance & Growth: Collect necessary documentation (agreements, CVs, applications, W9s, NPDB reports).
• Panel Maintenance & Growth: Coordinate with the Director of Operations to finalize fees.
• Special Assignments & Contract Negotiations: Lead contract renegotiations for existing physicians (agreements, pricing changes, special initiatives).
• Special Assignments & Contract Negotiations: Handle complex client requests, especially those involving niche specialties or urgent network gaps.
• Special Assignments & Contract Negotiations: Assist physician reviewers with technical issues or case-specific inquiries.
• Special Assignments & Contract Negotiations: Fulfill high-priority OSRs by recruiting appropriate specialists and providing daily updates on progress.
• Special Assignments & Contract Negotiations: Collaborate with operations to ensure network alignment with business needs.
• Additional Duties: Support other projects and tasks as assigned by leadership.
• Additional Duties: Stay current on industry trends and compliance requirements.
• Qualifications: Education: Associate's or Bachelor's degree preferred.
• Qualifications: 3–5 years of physician recruitment experience in a healthcare or insurance environment.
• Qualifications: Familiarity with provider networks and healthcare operations is strongly preferred.
• Qualifications: Deep understanding of physician recruitment, medical specialties, and related terminology.
• Qualifications: Strong negotiation and communication skills.
• Qualifications: Working knowledge of federal/state healthcare compliance standards.
• Qualifications: Excellent time management, critical thinking, and organizational abilities.
• Qualifications: Proficiency in Microsoft Office and general computer systems.
• Working Conditions: Primarily remote with extended periods of computer work.
• Working Conditions: Occasional lifting, bending, or travel may be required depending on business needs.
• Technical Requirements (Remote Work): Must supply and maintain reliable, high-speed internet.
• Technical Requirements (Remote Work): An uninterrupted internet connection is a requirement for this role.

Physician Recruiter

• Lead and manage the day-to-day operations of the disability claims team.
• Supervise daily operations including case assignments and performance management.
• Oversee scheduling, quality assurance, and administrative functions; ensure all intakes are addressed promptly.
• Train, mentor, and develop team members to achieve individual and team goals.
• Drive client satisfaction by ensuring inquiries and communications are addressed timely.
• Monitor and assess team performance against established KPIs and metrics.
• Identify areas for process improvement and implement action plans.
• Collaborate with other departments to enhance operational efficiencies.
• Maintain accurate records and documentation for company policy and regulatory standards.
• Prepare reports on team performance and present findings to management.
• Perform other duties as assigned.

Disability Operations Supervisor

Accountant

The Senior Accountant plays a crucial role in supporting the daily, monthly, and annual activities of the finance department. The Sr. Accountant should possess analytical & problem solving skills, be detail oriented, have solid conceptual thinking, and must be able to apply these traits to large datasets.
Dane Street’s success relies on individual and team contributions every day. We care for our customers, each other, and Dane Street. It’s the responsibility of all of us to maintain a positive working environment that promotes client satisfaction and results.

Senior Accountant

• Program Leadership & Strategy:
• Lead the overall operations of Dane Street's Independent Dispute Resolution (IDR) program, ensuring compliance with federal regulations and guidelines.
• Contribute to the strategic direction of the IDR program, identifying opportunities for growth and efficiency.
• Stay informed of any changes to the IDR program and regulatory landscape, including updates from CMS, HHS, and DOJ.
• Operational Management & Workflow:
• Oversee the end-to-end workflow of IDR cases, from government portal intake to final determination.
• Optimize processes for case review, including the utilization of arbitrators and coders, to ensure timely and accurate determinations.
• Manage the integration and use of AccessDS for case tracking and management.
• Collaborate with the legal team to ensure all processes adhere to legal requirements and to address any contractual hurdles.
• Team Management & Development:
• Lead and manage a team of arbitrators, coders, and CSRs, including recruitment, training, and performance evaluation.
• Ensure arbitrators are credentialed and trained according to program requirements and internal standards.
• Oversee ongoing quality assurance for all reviews, reducing clarification needs and speeding up turnaround times.
• Financial & Administrative Oversight:
• Collaborate with the finance team to manage billing and revenue processes, focusing on upfront fees and payment collection from non-paying parties.
• Oversee the relationship with the escrow partner to ensure seamless handling of funds during the IDR process.
• Manage the budget for the IDR program, validating estimated numbers and timeframes.
• Stakeholder Communication & Relationship Management:
• Maintain effective communication with the Tri-Departments (CMS, HHS, DOJ) and other relevant entities.
• Address challenges related to incomplete information from initiating and non-initiating parties.
• Represent Dane Street in relevant industry discussions and conferences, such as NAIRO meetings.

Group Health Operations Manager, RN/LPN

Physician Recruiter

Disability Operations Supervisor

Senior Accountant

VP of Operations, Independent Dispute Resolution