- Company Name
- Rainbow of Resilience (rorrightwhereur)
- Job Title
- Operations Manager
- Job Description
-
**Job Title**
Operations Manager – Outpatient Behavioral Health Practice
**Role Summary**
The Operations Manager directs all administrative and operational activities of an outpatient behavioral health practice. The role ensures continuous regulatory compliance (OMHAS, Joint Commission), oversees credentialing and payer relations, develops and standardizes operational workflows, and partners with leadership to drive strategic growth and quality improvement.
**Expectations**
- Maintain full compliance with state and national regulations.
- Ensure audit/readiness readiness and timely policy updates.
- Deliver efficient, scalable operational systems that support clinical excellence.
- Contribute to strategic planning and organizational growth initiatives.
**Key Responsibilities**
1. **Regulatory and Compliance Oversight**
- Enforce OMHAS and Joint Commission standards.
- Prepare for audits, inspections, and renewals.
- Review and update policies in collaboration with clinical teams.
2. **Licensing, Credentialing, and Payer Relations**
- Manage credentialing/recredentialing for all providers.
- Oversee EDI enrollments, payer registrations, and compliance maintenance.
- Maintain provider databases, monitor expirations, and coordinate updates with payers.
3. **Operational Process Development**
- Design, document, and monitor workflows for client intake, insurance verification, clinical documentation, staff onboarding, and ongoing education.
- Standardize procedures to maximize efficiency and consistency.
- Create tracking systems for compliance, quality, and performance metrics.
4. **Strategic Collaboration**
- Partner with leadership on fee structures, emergency plans, documentation standards, and quality initiatives.
- Support internship, community, and university partnership programs.
- Execute initiatives aligned with organizational goals.
5. **Industry and Practice Advancement**
- Stay current on behavioral health trends, payer updates, and regulatory changes.
- Recommend and implement proactive adjustments to sustain operational excellence.
**Required Skills**
- In-depth knowledge of OMHAS, Joint Commission, and payer compliance requirements.
- Proven credentialing and insurance enrollment experience.
- Ability to design, implement, and optimize workflow systems.
- Strong communication, organizational, and leadership abilities.
- Proficiency in EHR systems, payer portals, and data management tools.
- Analytical thinking and problem‑solving skills.
**Required Education & Certifications**
- Bachelor’s degree in Business Administration, Healthcare Management, or related field (Master’s preferred).
- Minimum 3–5 years of healthcare operations experience, preferably in behavioral health or outpatient services.
- Certifications in healthcare operations or compliance (e.g., HCPC, PMP) are an asset.