Senior Director, Wealth CIO Operations – Execution
TIAA
Vice President – Claims and Provider Operations
Healthfirst
full-time
Posted on:
Location Type: Hybrid
Location: New York City • New York • 🇺🇸 United States
Visit company websiteSalary
💰 $193,100 - $375,870 per year
Job Level
Lead
About the role
- leads the delivery of provider data management, original claims processing, and claims rework functions
- ensures the successful operation and delivery of Healthfirst claims and provider payment services for federal, state, and commercial programs
- works to increase provider data capabilities, improve accuracy, and ensure compliance while advancing sponsorship model
- provides strategic oversight and leadership to claims-related root cause analysis and determinations
- directs and ensures the efficient and compliant operational management of Claims with emphasis on execution and outcomes
- develops strategic plans to ensure modern and efficient claims management and provider payment
Requirements
- Bachelor’s Degree from accredited program or equivalent work experience
- Working experience facilitating business objectives within a highly regulated industry
- Experience leading teams, both managers and individual contributors, to identify opportunities, develop, and execute action plans
- Proven experience in root-cause resolution and managing cross-functional projects
- Proven ability to develop strong interpersonal relationships, as a leader and team member with experience communicating and influencing impact and progress to senior leadership level
- Successful track record developing creative, workable strategies and tactics to accomplish division, corporate and plan goals
- Experience managing budget and allocating resources with reputable record in the execution of complex projects and programs while managing operational and health care cost budgets
Benefits
- medical, dental and vision coverage
- incentive and recognition programs
- life insurance
- 401k contributions
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
claims processingprovider data managementroot cause analysisproject managementbudget managementresource allocationstrategic planningcompliance managementclaims rework
Soft skills
leadershipinterpersonal relationshipscommunicationinfluencingteam collaborationproblem-solvingstrategic thinking
Certifications
Bachelor’s Degree
