State of NH, Claims Manager
3 weeks ago
State of NH, Claims Manager
Location
: Manchester, NH; Woburn, MA. This position will work a hybrid model (remote and office). The ideal candidate must live within 50 miles of the Elevance Health PulsePoint locations listed above.
The
State of NH, Claims Manager
oversees an operations unit(s); executes or supports strategies to deliver industry leading digitized service results. Partners across departmental lines to support further penetration of operational digitization, E2E efficiencies, lowered administrative costs and an excellent member and provider experience. Supports effective achievement of digital operations organizational objectives.
How you will make an impact:
Plans, directs, and controls the resources and efforts of an operational unit within blended Digital Operations organization
Supports objectives of the company and the blended Digital Ops organization
Supports digitization initiatives by demonstrating understanding current operational business processes that digitization does/can enable
Assists in budget development
Serve as a functional expert and guide team members towards new ways of working and leveraging digital solutions
Ensures compliance with state and federal regulations
Participates with peers and digital operations leadership to deliver on tactical plans and objectives
Provides direct, daily oversight of transactional operations staff, ensuring production levels and quality are maintained
Monitors, on a daily basis, inventory levels, aging and quality and takes immediate corrective actions as needed
Hires, trains, coaches and evaluates performance of direct reports
Provides leadership in motivating subordinates to maintain high production and quality levels
Provides quality control services by monitoring work results of direct reports
Develops a strong team through training and effective organizational development practices.
Manages processes and receives assignments in the form of objectives and framework on how to meet goals
Manages resources (people, material, support) to get things accomplished within unit of responsibility
Identifies and resolves hurdles for assigned area/group
Leverage reporting and analytics tools, continually monitors procedures and operational metrics to ensure these are met by staff
Manages across geographically diverse associates and vendor partners
Builds strong partnerships with market and digital leads, Benefits Administration, Provider Engagement and Contracting, Sales and Internal Audit
Effectively interfaces with external contacts, e.g. customers, vendors and agencies
Minimum Requirements:
Requires a BA/BS in Information Technology or Business Administration, 3+ years' of experience leading technology (application development, configuration, maintenance or implementation and support) teams and/or cross functional project (technology and operations) teams and a minimum of 2 years of management experience in managed care and/or health insurance industry; or any combination of education and experience which would provide an equivalent background.
Preferred Skills, Capabilities, and Experiences:
3+ years' experience leading claims teams in a large healthcare payor setting
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