Note: The job is a remote job and is open to candidates in USA. Western Growers Health provides group health benefit plan administration through Western Growers Health and Pinnacle Health Solutions. The AVP, Operations sets the strategic direction and oversees administration functions including new business implementation, client renewals, billing, invoicing, financial reporting, benefit distribution, and provider contracting. The role leads operational planning, performance management, process improvement, staffing, budgeting, and cross-functional execution.
Responsibilities
- Own the enterprise strategy and operating model for Installation, Benefit Distribution, and Finance Administration (premium billing, non-premium invoicing and remittance) functions across WGAT and PCMI
- Set departmental goals, KPIs, and service standards for installation quality, billing accuracy and timeliness, and client satisfaction, and report performance to executive leadership
- Own the department budget and staffing plan across installation, billing, and benefit distribution activities
- Serve as the executive-level escalation point for the most complex installation, billing, and benefit distribution issues
- Represent installation, billing, and financial reporting performance in senior leadership and WGAT Trustee-level reporting forums
- Evaluate emerging regulatory requirements (e.g., ERISA, CDI, DOL) and industry trends, and set the direction for how the organization adopts them
- Direct the oversight of installation processes and premium billing/non-premium invoicing and remittance processes for new and renewal customer implementations, delegating execution to the Director, Administration and their team (Manager, Finance Administration; Supervisor, Benefit Distribution and Installation)
- Ensure administrative, billing, and invoicing processes and procedures maximize employee production and compliance with ERISA, CDI, and DOL regulations
- Direct the development of KPI reporting for weekly VP, monthly Senior Leadership, and quarterly WGAT Trustee reporting on installation, billing, and benefit distribution performance
- Collaborate with internal stakeholders, review contracts, and provide business reporting related to implementation and billing
- Hold the Director, Administration accountable for timely resolution of installation, billing, and benefit distribution issues, and personally engage on the highest-impact escalations
- Partner with other department leaders and key stakeholders on driving new process implementation with a focus on intercompany transparency, communication, and data sharing
- Plan, deploy, and lead lean activities that produce significant cost savings through productivity, quality, and waste-reduction improvements in installation, billing, and benefit distribution
- Oversee and guide the development of comprehensive process improvement plans to be shared with stakeholders
- Develop and promote data-driven solutions for installation, billing, and benefit distribution
- Train frontline supervisors on continuous improvement and leadership skills
- Build, develop, and lead the Director, Administration across Installation, Benefit Distribution, and Finance Administration as well as Manager, Provider Operations, ensuring clear roles and service expectations at every level (including the Manager, Finance Administration and the Supervisor, Benefit Distribution and Installation)
- Develop a culture of real, personal accountability by modeling the behavior that defines it, cascading that standard through the leadership team
- Instill a culture of safety and expectation across the installation and benefit distribution function
- Hold the Director, Administration accountable to high standards of performance and personal conduct, in a clear, helpful, straightforward way
- Conduct one-on-one conversations with the Director, Administration on a quarterly basis, focused on capabilities, impact, and effort
- Own staffing decisions — selection and hiring, role clarity, performance management, and correction/discipline/termination — using the “Outward Mindset Skills for Leaders” guide
- Ensure a robust mentorship, leadership, management, and technical training program is in place to continually develop staff
- Create a succession and career development plan for staff within area of responsibility
- Utilize all capabilities to satisfy one mission — to enhance the competitiveness and profitability of our members. Do everything possible to help members succeed by being curious and striving to understand what others are trying to achieve, planning and executing work in a helpful and collaborative manner, being willing to adjust efforts to ensure that work and attitude are helpful to others, being self-accountable, creating positive impact, and being diligent in delivering results
- Maintain internet speed of 40 MB download and 10 MB upload and router with wired Ethernet
- Maintain a HIPAA-compliant workstation and utilize appropriate security techniques to ensure HIPAA-required protection of all confidential/protected client data
- Maintain and service safety equipment (e.g., smoke detector, fire extinguisher, first aid kit)
- Maintain a clean DMV record and the ability to travel to locations throughout the U.S. (mainly California and Arizona) up to 25% of the time
- All other duties as assigned
Skills
- Maintain internet speed of 40 MB download and 10 MB upload and router with wired Ethernet
- Maintain a HIPAA-compliant workstation and utilize appropriate security techniques to ensure HIPAA-required protection of all confidential/protected client data
- Maintain and service safety equipment (e.g., smoke detector, fire extinguisher, first aid kit)
- Maintain a clean DMV record and the ability to travel to locations throughout the U.S. (mainly California and Arizona) up to 25% of the time
- The physical demands and work environment described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of the job, the employee is regularly required to talk or hear
- The employee frequently is required to stand, walk and sit
- The employee is frequently required to use hands to finger, handle, or feel objects, tools, or controls and reach with hands and arms
- The noise level in the work environment is usually moderate
Company Overview