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Senior Operations Manager
2 months ago
Your Role
The Appeals and Grievances division is dedicated to addressing our members' concerns through a structured process that ensures each issue is handled accurately, promptly, and in compliance with regulations. The Senior Operations Manager will report directly to the Senior Director of Operations. In this capacity, you will lead and support your team while also engaging with our members and specialized clients. Our leadership philosophy emphasizes the development of exceptional leaders at every level and the creation of opportunities for personal, professional, and financial growth. We seek leaders who thrive on innovative and analytical thinking, building and maintaining high-performing teams, achieving results ethically, and promoting continuous learning.
Your Responsibilities
In this position, you will:
- Oversee multiple teams, departments, or functional areas; drive results in alignment with strategic planning, cost management, and operational methodologies.
- Cultivate a positive workplace by effectively communicating the mission, vision, goals, roles, and expectations for team members; acknowledge top talent and team accomplishments; foster successful working relationships across the organization; ensure a safe and healthy work environment; and provide the necessary tools, time, and talent for success.
- Manage budgetary considerations, resource allocation, process enhancements, and technological advancements for the teams, departments, or functional areas under your supervision.
- Develop and execute the annual budget.
- Oversee several interrelated projects aimed at enhancing the organization's performance.
- Manage internal and regulatory audit activities.
- Drive quality improvement and efficiency within processes.
- Monitor case activities to ensure timely and accurate completion of all tasks.
- Analyze primary drivers of appeals and grievances, collaborating with upstream and downstream partners to alleviate member challenges.
- Implement significant improvements within the department by partnering with training and other key stakeholders.
Your Qualifications
- A bachelor's degree or equivalent experience is required.
- A minimum of 10 years of relevant experience, including at least 4 years in a management role, is necessary.
- Direct experience with Appeals and Grievances is essential.
- Experience with regulatory audits is preferred.
- Proven ability to build strong, sustainable relationships and effectively interact at all organizational levels.
- Capacity to manage complex situations and multiple responsibilities simultaneously while addressing immediate operational demands.
- Ability to present information clearly and concisely to diverse audiences.
Compensation Range:
The compensation range for this position is: $120,100 to $180,200 for California.
Note:
This range reflects the compensation for this and other positions at Blue Shield that fall within this pay grade. Salaries at Blue Shield are determined by various factors, including the candidate's experience, location, and current employee salaries for similar roles.
