DELTA DENTAL OF MISSOURI

Transcription

1 POSITION SPECIFICATION THE POSITION Reporting Relationships: Overall Responsibilities: The Chief Operating Officer (COO) will report directly to the President & Chief Executive Officer. Reporting directly to the COO is the Manager Customer Service, Manager Operations Support, Manager Claims Administration, Manager Project Services, Conversion Optimization Manager, and Manager Technical Operations. The COO is also indirectly responsible for an additional 80 positions that report through these managers. The Chief Operating Officer is responsible for planning and directing all internal operating functions involved with claims processing, customer service and related operational matters for Delta Dental of Missouri (including Delta Dental of South Carolina) and its subsidiary, Advantica. Claims processing for dental and vision claims exceeds 3.3 million claims annually. Customer service inquiries of 1.4 million contacts are handled by live agents, chat and IVR systems. This position directs the activities of a call center that supports individual and group dental and vision insurance products across the enterprise. The Chief Operating Officer advises the company s Board of Directors, management and employees about current processing policies and educates/informs this same group on related issues and policy changes that may impact the company and its supporting systems. This position serves as the company s primary liaison with external groups relative to operations matters. The COO also directs and manages all project management services throughout the enterprise via the Project Management Office (PMO). The PMO drives project planning and execution relative to support and enhancements to the enterprise s major operating systems and provides project management support to many corporate strategic initiatives. The incumbent also serves as the enterprise s Privacy Officer.

2 Page 2 Specific Responsibilities: Oversees the planning and allocation of resources to ensure that claims operations, customer service and project services are sufficiently staffed with properly trained personnel; reviews production and quality results to assure attainment of corporate objectives; and creates and implements operating policies/procedures. Reviews and approves production, training and standards for claims and customer service. This process includes observing and collaborating with managers and staff. Sets employment criteria and coordinates salary recommendations for all operations management and staff. This process includes the review and approval of impactful, strategic goals, as well as possessing an understanding of management and staff talent and performance. Maintains production levels to meet Guarantee of Service Excellence standards where they impact claims payment accuracy and timeliness; as well as call service quality and promptness. Through managers and staff, determines the proper development of user specifications for changes, enhancements, and further development of systems and rules used for claims processing and customer service. Identifies emerging technologies and trends in the dental and vision insurance industry and provides analysis and recommendations to the organization related to the impact on claims processing and customer service delivery. Researches and implements market leading dental and vision benefit processing policies in conjunction with peers and oversees the policy application to the company s systems within operations. Reviews and monitors claims processing status and procedures with management team to determine any changes needed to improve service. Oversees the user testing and implementation of new processing procedures. Through the PMO, directs and manages the development of projects within the portfolio. Directs the activities of the PMO relative to definition of scope, goals and deliverables of projects that support business goals. With the Manager Project Services, develops best practices, techniques and tools for project planning, execution, project management, ongoing milestone/deliverable tracking, communication and key performance metrics. Responsible for the preparation, maintenance and monitoring of the annual operating budget for the Claims, Customer Service, and Project Services departments of the enterprise. Monitors performance and reports variances. Maintains current knowledge of trends and industry developments impacting areas of responsibility; monitors the level and quality of services provided and develops, recommends and implements improvements to promote efficiency and increases the effectiveness

3 Page 3 of the departments. Represents Delta Dental of Missouri on various Delta Dental Plans Association Committees, as assigned. Provides executive representation at client and prospect meetings as the subject matter expert in the areas of claims processing and customer service. As a member of the Senior Leadership Team, this position provides crucial input to the strategic planning process and its methods of execution for Delta Dental of Missouri and its subsidiaries. THE INDIVIDUAL Education: Experience: A Bachelors Degree in business or related program; Masters Degree preferred. The COO must first and foremost be a highly effective leader and manager of people who possesses not only the operating, but also the business and general management skills to drive an integrated operating model for the company. The successful candidate will have at least 10-plus years of progressively more responsible experience, ideally in the number one operating role with a successful, dynamic, growing health insurance company. It is strongly preferred that this individual has served as the operations executive during a sustained period of operational improvement, growth and other development and operational improvement activities in the insurance arena. Alternatively, individuals who have distinguished themselves as a number two in a health insurance company and are clearly ready for the COO role will also be considered. It will be critical for this individual to bring strong claims processing, customer service, call center operations and overall strategic operating experience. In addition, experience with implementing Lean Six Sigma operational improvement initiatives will also be preferred. Previous background working with a diverse set of constituents and a board of directors will also be important. Delta Dental seeks an exceptional individual who has demonstrated superior analytical, communication, and overall operating and business leadership skills. It will be expected that this individual will develop an extremely strong partner relationship with the CEO and other members of the senior management team and board. He or she must be viewed as a team player and possess the independence of thought and opinion to provide candor and honesty when making key business, clinical and policy decisions. Key Personal Competencies: Leadership This individual should have the track record of proven leadership with the ability to select, retain and mentor high performance teams.

4 Page 4 Collaborative and Team Building Style This person should have a highly effective interpersonal and relationship building skills, both at the employee/associate level, as well as with key clients and other constituencies. Commitment to Customer Service and Quality Demonstrated support for maintaining the highest level of customer service to all Delta Dental constituents. High Energy and Communication Skills This person should have a proven ability to communicate effectively at all levels of the organization related to ongoing operational developments and the potential impact on other parts of the company. Hands-On Management Style Prior success in a fast-paced, entrepreneurial environment and clear evidence of a hands-on, detailoriented management style. Performance Orientation and Mission-Driven Strong work ethic, keen performance orientation, along with an appreciation and embrace of the company s mission and core values including integrity, trust, respect, innovation, stewardship, excellence and celebration. Intellect and Analytical Ability This person should have sophisticated, broad-gauged business knowledge, strong analytical foundation, and a clear strength in evaluating the impact of strategic and operational decisions within the company. THE COMPANY Delta Dental of Missouri Delta Dental of Missouri is a nonprofit 501(c)(4) organization with a social mission to improve oral health in its communities. This mission drives their quest to eradicate chronic oral disease and improve overall health in the states of Missouri and South Carolina. Delta Dental s commitment to its mission motivates it to be better in all they do, because the more successful they are in their business endeavors, the more they can contribute to improving oral health and welfare. Delta Dental shares a mission with several charitable organizations that serve the oral healthcare needs of children and adults across our states. Through its own initiatives, exciting collaborations and supportive relationships, Delta Dental is truly helping to make a difference. Delta Dental of Missouri is the state s dental benefits leader, with 2.0 million members who are covered through more than 2,000 companies, both large and small, as well through individual plans purchased directly from Delta Dental of Missouri. These members have access to the ninety-four percent of practicing dentists in Missouri who participate in one or both of Delta Dental s networks: Delta Dental PPO Network and Delta Dental Premier Network. Nationally, Delta Dental offers the largest proprietary network of participating dentists in the country.

5 Page 5 Today Delta Dental of Missouri offers dental and vision benefits in Missouri, as well as in South Carolina since The company proudly supports the Delta Dental Land of Smiles educational touring theater program, Delta Dental Health Theatre, Give Kids a Smile, Missouri Dental Mission of Mercy and South Carolina Dental Access Days. Location: Website: St. Louis, MO TO APPLY FOR THIS POSITION, submit your resume to Pam Sprague a psprague@chartwellpartners.com. CONTACT INFORMATION: Bill Ward Partner bward@chartwellpartners.com Office: Cell: Pam Sprague Senior Associate psprague@chartwellpartners.com Office: Cell: Gayla Ownbey Executive Assistant gownbey@chartwellpartners.com Office: Fax: