Chief Operations Officer

Dane Street Goverment Servcies is seeking a highly experienced and strategic Chief Operations Officer to lead our operational teams and be a key member of the Management Team. Dane Street’s Government Services provides specialized, compliant solutions that support federal and state program needs with efficiency, accuracy, and integrity. Services include Independent Dispute Resolution (IDR), Acceptable Clinical Evidence (ACE) reviews, and Medical Disability Examinations (MDE),

Dane Street partners with organizations to deliver clear outcomes that meet both operational and clinical standards. We serve as a trusted resource, bringing clarity, consistency, and confidence to complex review processes.This role is critical in ensuring the efficient and compliant operation of our IDR services, which addresses the reconciliation and adjudication of bills for air ambulance, excessive ER charges, and out-of-network hospital charges, as mandated by the No Surprises Act. The successful candidate will oversee all operational aspects, from workflow optimization to team management and strategic growth, in a dynamic and evolving regulatory landscape.

Responsibilities:

• Program Leadership & Strategy:
• Lead the overall operations for all products, ensuring compliance with federal regulations and guidelines.
• Contribute to the strategic direction and identify opportunities for growth and efficiency through current products and future lines of business.
• Stay informed of any changes to the Government program and regulatory landscape, including updates from CMS, HHS, and DOJ.
• Operational Management & Workflow:
• Oversee the end-to-end workflow of IDR cases, from government portal intake to final determination.
• Optimize processes for case review, including the utilization of arbitrators and coders, to ensure timely and accurate determinations.
• Oversee the operational functions of MDE and ACE to ensure quality and production goals are met.
• Manage the integration and use of AccessDS for case tracking and management.
• Collaborate with the Management team to ensure all processes adhere to legal requirements and to address any contractual hurdles.
• Team Management & Development:
• Lead and manage a team who manages arbitrators, coders, and CSRs, including recruitment, training, and performance evaluation.
• Ensure arbitrators are credentialed and trained according to program requirements and internal standards.
• Oversee ongoing quality assurance for all reviews, reducing clarification needs and speeding up turnaround times.
• Financial & Administrative Oversight:
• Collaborate with the finance team to manage invoicing, billing and revenue processes, focusing on upfront fees and payment collection from non-paying parties.
• Oversee the relationship with the escrow partner to ensure seamless handling of funds during the IDR process.
• Manage the budget for all products, validating estimated numbers and timeframes.
• Stakeholder Communication & Relationship Management:
• Maintain effective communication with the Tri-Departments (CMS, HHS, DOJ) and other relevant entities.
• Address challenges related to outside vendors.
• Represent Dane Street in relevant industry discussions and conferences.

Qualifications:

• Proven experience in operations leadership, preferably within healthcare, dispute resolution, or a related regulatory environment.
• Understanding of the Government Services such as Independent Dispute Resolution (IDR) process, MDE and ACE programs as well as the No Surprises Act.
• Experience managing and optimizing complex workflows and processes.
• Demonstrated ability to lead and develop high-performing teams.
• Excellent communication, negotiation, and problem-solving skills.
• Ability to adapt to a rapidly changing regulatory environnment

A deep understanding of business strategy, cross-departmental operations, and executive leadership. Requirements include 5-10 years of senior management experience, a proven ability to manage complex operations, and degrees in business or similar study.

Join our team at Dane Street Goverment Services. Enjoy a comprehensive benefits package designed to support your well-being and peace of mind. We offer a range of benefits including medical, dental, and vision coverage for you and your family. Additionally, we offer voluntary life insurance options for you, your spouse, and your children. We also offer other voluntary benefits which include hospital indemnity, critical illness, accident indemnity, and pet insurance plans. Employees receive basic life insurance, short-term disability, and long-term disability coverage at no cost.. Our 401k plan with a company match helps you plan for your future. Apple equipment and a media stipend are provided for remote workspace.