Salary
💰 $152,500 - $208,110 per year
About the role
- Effectively direct customer service and claims processing operations on a departmental/product/program basis to meet organizational and customer needs and applicable goals
Leverage key internal and external relationships to access the information, products and resources necessary to successfully support the core activities of customer service and claims processing
Direct departmental operations to ensure timely, consistent achievement of prescribed goals including departmental performance targets, divisional quality & production standards, key enterprise priorities, Service Level Agreements (SLAs) and Performance Guarantees (PGs)
Hire, develop and retain high quality staff including coaching & mentoring, evaluating job performance, providing meaningful, timely feedback and appropriately addressing performance issues
Manage departmental budget, including all salary and non-salary costs, within established guidelines
Leverage knowledge, experience, data and tools to forecast, prepare for and respond to changes in inventory and/or greater business need/climate
Champion process/ workflow improvements within or across departments/divisions
Develop/influence successful partnerships, interfaces and communications with key enterprise departments to drive goal achievement
Capitalize on existing technology, optimizing system capabilities
Identify and elevate opportunities to incorporate new technology into processes and workflows
Lead high profile internal and/or external workgroups, presenting findings to appropriate leadership teams
Accountable for maintaining effective internal controls over the processes and transactions under areas of responsibility
Requirements
- High School Diploma/GED required
Bachelor degree preferred or relevant experience in lieu of degree
Minimum of ten (10) years management experience required
Successful track record managing large staff groups (150+ FTEs) preferred
Knowledge of health insurance products required
Experience directing health plan operations preferred
Experience managing in a fast paced, high volume, transaction-driven environment necessary
Call Center/insurance claim management experience preferred
Experience managing in a Union environment preferred
Requires familiarity with systems implementation, insurance terminology, and health plan operations
Ability to manage multiple, dynamic work assignments and priorities, as well as diverse work/product teams
Ability to communicate successfully with all levels of management, including those at the highest level of the organization
Proven project management skills
Strong leadership, strategic problem solving, analytical and interpersonal skills
Exceptional written and verbal communication skills
Travel: Min of 10% travel may be required