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Manager of Claims Health Plans
3 months ago
Manager of Claims Health Plans
Pride Health is seeking a Manager of Claims Health Plans for one of its healthcare clients in Oregon.
This is a Permanent role with competitive pay and benefits.
This is a Hybrid position and will be onsite in Corvallis 2-3 times a week or more if needed.
Length of Assignment: Permanent Full Time
Pay range - $73,000 to $100,000 per annum (Depending upon the final discussion with the Client HR)
Location – Corvallis, Oregon (97330)
Shift – Monday to Friday – Day shift
Job Summary
Oversees and manages the Client’s Claims Department. They need a candidate with strong management experience.
Job Duties
· Is responsible for accurate and timely claims processing for all programs administered by Client.
· Provides oversight to staff and ensures that the organization's performance expectations, financial standards, and goals are achieved.
· Enhances department bench strength by hiring, coaching, and mentoring direct reports.
· Responsible for the completion and success of all internal and external claims audits.
· Analyzes claims data and ensures compliance requirements are met.
Requirements
· Bachelor's degree in healthcare or a related field, or equivalent direct claims experience required.
· Three (3) years of management experience in a health plan claims department is required.
· Experience or training in the following required:
o Collecting, analyzing, and displaying statistical reports by computerized technology.
o Basic medical terminology.
· Medicare and/or Medicaid experience preferred.
· Leadership - Inspires, motivates, and guides others toward accomplishing goals. Achieves desired results through effective people management.
· Conflict resolution - Influences others to build consensus and gain cooperation. Proactively resolves conflicts positively and constructively.
· Critical thinking – Identifies complex problems. Involves key parties, gathers pertinent data, and considers various options in the decision-making process. Develops, evaluates, and implements effective solutions.
· Communication and team building – Leads effectively with excellent verbal and written communication. Delegates and initiates/manages cross-functional teams and multi-disciplinary projects.
Company DescriptionPride Health is a leading minority-owned healthcare recruitment & staffing firm that offers highly customized business process solutions at cost-effective prices.Headquartered in New York City as a top minority supplier, PRIDE Health offers a broad geographic reach with offices throughout the U.S., India, and Brazil. Leveraging more than 20 years of experience, PRIDE has enhanced its core competency of IT staffing services by creating client-centric, cost-effective IT, and business process solutions. PRIDE serves Client-Partners in the healthcare, IT, financial services, retail and insurance industries offering both Direct Hire and Temporary Staff of Healthcare Professionals, Vendor Management Systems, IT Hardware Procurement Services, and Business Processing Outsourcing.
Temporary, Contract, Per Diem & Direct Hire staffing solutions are only part of what we can offer our clients.Company DescriptionPride Health is a leading minority-owned healthcare recruitment & staffing firm that offers highly customized business process solutions at cost-effective prices.\r
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Headquartered in New York City as a top minority supplier, PRIDE Health offers a broad geographic reach with offices throughout the U.S., India, and Brazil. Leveraging more than 20 years of experience, PRIDE has enhanced its core competency of IT staffing services by creating client-centric, cost-effective IT, and business process solutions. PRIDE serves Client-Partners in the healthcare, IT, financial services, retail and insurance industries offering both Direct Hire and Temporary Staff of Healthcare Professionals, Vendor Management Systems, IT Hardware Procurement Services, and Business Processing Outsourcing.\r
\r
Temporary, Contract, Per Diem & Direct Hire staffing solutions are only part of what we can offer our clients.
