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Vice President of Claims

2 months ago

Westborough, United States Health Plans Inc Full time
Job DescriptionJob DescriptionHealth Plans, Inc. (HPI) is a New England-based Third Party Administrator (TPA) of self-funded health and benefit plans. HPI was founded in 1981 to provide comprehensive health plan administration to employers, municipalities and Taft-Hartley plans. Health Plans has grown to become an industry-leading TPA by offering customized self-funded benefit plans to employers, combined with superior customer service and investment in the latest administrative and data-mining technology, and reinsurance (stop-loss) security.

Summary:

The Vice President of Claims Operations oversees the Claims, Technical Resource Unit, Reinsurance, Enrollment, Billing & Payment Configuration, and Cobra areas of the business. The Vice President of Claims Operations also oversees the development of goals and employee bonus measures, and regularly tracks progress towards meeting those goals.

As a member of the senior leadership team of Health Plans, the Vice President is responsible for participating in strategic planning. The Vice President leads the advancement of these areas in terms of: regulatory compliance; effective and efficient operations; automation and adoption of cutting edge technology and practices.

Duties and Responsibilities:

  • Oversees the assigned departments and ensures accurate and timely processing of appropriate activities.
  • Participates in setting corporate strategy and direction.
  • Identifies and directs activities related to process improvement and automation for responsible functions.
  • Provides direct supervision of the Director of Claims & TRU, Director of Enrollment and COBRA operations and Director of Billing, Payment and Enrollment Configuration.
  • Maintains current and thorough knowledge of Federal, State and local laws and regulations related to functional areas.
  • Maintains current and thorough knowledge of accounting principles and practices to maximize compliance and revenue.

Minimum Education Requirements:

  • Bachelor’s Degree

Minimum Experience Requirements:

  • Ten or more years’ experience in health benefits and/or manage care industries with a track record of increasing management responsibilities.
  • Ability to provide leadership in alignment with organizational goals.
  • Ability to effectively coordinate external relationships.
  • Communicates effectively, both verbally and in writing.
  • Ability to work both independently and as a member of the management team.
  • Ability to work within specified timeframes and meet deadlines.
  • Recognize and maintain confidentiality of work materials as appropriate.
  • Advanced proficiency in in Microsoft Office, including Word, Excel, Outlook and PowerPoint.

Why choose us?

  • Our space is a reflection of who we are—innovative, open, and collaborative.
  • Love to get creative? We do too. Brainstorm in one of our team break-out rooms.
  • We think feeling your best is an important factor in producing great work, so we embrace a “smart casual” dress code and work at ergonomic desks.
  • Need to reenergize? Take a break to chat in the onsite café, go for a walk on one of the beautiful trails in our office park, or get in a quick workout at one of the campus gyms.
  • We offer our employees flexible work arrangements including hybrid options.
  • We’re a people-first company and value giving back to our community. Ask us about our RISE Committee & and volunteer opportunities.

Benefits

We care about you and believe the greatest gift you can give yourself, your family, and the world is a healthy you We offer a comprehensive and competitive benefits package to help you lead a happy, healthy life. Check out some of the benefits we offer to our employees:

  • Medical, Dental and Vision Coverage
  • Prescription Drug Coverage
  • Fitness Reimbursement Benefit
  • Tobacco Cessation Program
  • Employee Assistance Program
  • Flexible Spending Account & Health Savings Account
  • 401(k) and Profit-Sharing Plan
  • Quarterly Bonuses
  • Generous Paid-Time Off
  • Volunteer Days
  • Education Assistance & Professional Development Opportunities
  • ….and much much more

So, think you want to join the HPI team? We hope to hear from you

You can read more about us at hpitpa.com/about-us/careers/

EEO/AA/M/F/Vet/Disability Employer