Manager of Operational Excellence
1 week ago
Blue Shield of California is seeking a highly skilled Manager of Operations to lead our Appeals and Grievances team. As a key member of our organization, you will be responsible for resolving member concerns through a regulated process.
About the Role- Provide leadership and support to your team, interacting with members and specialty clients.
- Develop and present updates on case activity, discussing trends and observations with our regulator.
- Serve as a primary speaker for regulatory audit activity.
- Lead a team, department, or functional area, overseeing planning, cost management, and methods.
- Demonstrate BSC Leadership Behaviors, fostering a great place to work and building successful relationships across the organization.
- Direct and control the activities of one or more departments or functional areas through subordinate supervisors/team leads.
- Establish operational objectives for departments or functional areas and participate in establishing group objectives.
- Ensure team processes are efficient and effective to manage case work timely and accurately.
- Improve quality results through training and oversight.
- Establish audit readiness across your team and in partnership with peers.
- Trend top drivers of appeals and grievances, working with upstream and downstream partners to reduce member pain points.
- College degree or equivalent experience.
- Minimum 7 years prior relevant experience, including 3 years of management experience.
- Understanding of basic management approaches, including work scheduling, prioritizing, coaching, and process execution.
- Knowledge of Blue Shield of California's mission and business plan.
- Functional expertise within the area of responsibility.
- Advanced knowledge of job area, usually obtained through advanced education combined with experience.
- Strong knowledge of the Appeals and Grievances process.
- Experience interacting directly with healthcare regulators.
- Regulatory audit experience.
- Ability to handle complex situations and multiple responsibilities simultaneously.
The pay range for this role is $96,500 to $144,800 for California.
Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade.
Blue Shield salaries are based on a variety of factors, including the candidate's experience, location, and current employee salaries for similar roles.
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