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Inova Health System

Falls Church, Virginia

Kaiser Permanente

Atlanta, Georgia

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Crawford & Company

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Temple, Texas

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Banner Health

Greeley, Colorado

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Salt Lake City, Utah

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Banner Health

Mesa, Arizona

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Middleton, Wisconsin

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Kingsland, Texas

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Hot Springs, Arkansas

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Baylor Scott & White Health

Fredericksburg, Texas

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Palm Coast, Florida

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Jackson, Mississippi

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Baylor Scott & White Health

Georgetown, Texas

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Marion, Illinois

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Baylor Scott & White Health

Austin, Texas

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AdventHealth

Altamonte Springs, Florida

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Hot Springs, Arkansas

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ChristianaCare Health System

Newark, Delaware

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Bonham, Texas

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Bonham, Texas

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Durham, North Carolina

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Director of Health Services Operations
JOB SUMMARY: Responsible for management and implementation of all operational and functional support for the Health Plan?s Health Services Division (HSD). Directs and coordinates all operations to ensure complete compliance with policies/procedures, accreditation and regulatory standards. Coordinates and implements IS programs/management for support of HSD Programs. WHAT IS EXPECTED (Essential Functions): Coordinates and directs SWHP health services: Responsible for the management and oversight of the HSD functions. The Director works closely with staff from Intake Support, Utilization Management, Case Management, Claims Nurse Review Operations, Appeals and Grievance, and Monitoring and Training units on these review activiti


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