Microsoft 365

Operations Director, SPBM

Microsoft 365

full-time

Posted on:

Origin:  • 🇺🇸 United States • Tennessee

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Job Level

Lead

About the role

  • Responsible for strategic and tactical execution and management of claims, contact center and various other operations
  • Manage Operations team(s), including supervision of managers and supervisors
  • Oversee financial outcomes, including claims loading, adjudication, and payments
  • Manage all aspects of operations and ensure efficiency; develop and implement strategic plans aligned with company objectives
  • Meet financial and performance goals, including budget preparation
  • Provide vision for call center goals and lead a multi-site team; foster a collaborative, employee-focused environment; provide ongoing formal training
  • Conduct data analysis and present insights; establish and monitor key performance indicators (KPIs); implement best practices and drive process improvements for scalability and efficiency
  • Manage cross-functional projects; collaborate with clinical, IT, and other departments; own pharmacy and vendor relationships for claims processing, call routing, reporting, and communication
  • Vendor and client-facing responsibilities as needed; support corporate initiatives
  • Oversee call center operations, ensuring service quality and adherence to metrics; implement strategies for customer loyalty and consistency in messaging

Requirements

  • 5+ years of experience successfully managing complex operations
  • 5+ years in healthcare-related operations roles
  • Preferred knowledge of Pharmacy Benefit Management (PBM) operations and industry
  • Strong strategic thinking and problem-solving abilities
  • Ability to prioritize work for cross-functional teams
  • Excellent people leadership skills with servant leadership attributes
  • Proficiency in Microsoft Office, email, and internet tools
  • Experience in Call Center Software Management
  • Expertise in Operations Team Management
  • Strong verbal and written communication, presentation, and negotiation skills
  • Ability to engage with stakeholders effectively
  • Willingness to travel as needed to meet goals
  • Bachelor's degree in business, accounting, or related areas preferred