Head, Medical Operations

Background:
The Head of Medical Operations is a senior leadership role responsible for overseeing and managing the medical operations of the organization. This role requires a seasoned healthcare professional with a strong background in medical management, operational efficiency, and strategic leadership. The Head of Medical Operations will collaborate with cross-functional teams to ensure seamless delivery of health care service.

Responsibilities:
1. Provider Onboarding & Support: Lead the onboarding and training of healthcare providers, ensuring they are well-supported.
2. Network Management: Collaborate with provider network managers to expand and optimize the provider network.
3. Contract & SLA Oversight: Oversee contracts and Service Level Agreements (SLAs) with providers to ensure compliance and quality.
4. Quality Assurance: Generate reports and conduct audits to uphold service standards and regulatory requirements.
5. Patient Care Optimization: Work with medical staff to enhance patient care pathways and clinical protocols.
6. Telemedicine Implementation: Develop and manage telemedicine initiatives to expand access to care and improve patient engagement.
7. Tariff Negotiation: Lead tariff negotiations and conduct regular reviews.
8. Team Leadership: Mentor and develop a team of medical professionals, fostering a culture of growth and accountability.
9. Cross-Functional Collaboration: Partner with departments like Underwriting, Sales, and Finance for effective service delivery.
10. Case & Claims Management: Oversee case management and manage provider relations for efficient claims processing.
11. Concierge Services: Develop and implement concierge services to improve patient experiences and streamline access to care.
12. International Relations: Build relationships with international providers to enhance service offerings.

Requirements and Skill:
1. Medical Doctor (MD) degree with an active medical license.
2. Proven experience in medical management and operations leadership roles.
3. 8+ Years experience in the HMO industry
4. Strong understanding of healthcare regulations, compliance, and quality assurance.
5. Excellent communication, leadership, and interpersonal skills.
6. Ability to make strategic decisions and drive organizational change.