Manager, Configurations And Claims Operations

Job Type
Full-time
Description
Plan, prioritize, coordinate and monitor activities in the department to ensure accurate, timely and efficient service. Manage, train and evaluate staff to achieve and maintain department standards. Develop and deliver programs that support business needs.
Essential Functions
Develop and maintain strategic partnerships with various Line of Business (LOB) counterparts; provide business partners and key executives with customer perspective and facilitate timely response to complex business challenges and opportunities
Recommend and implement procedural and systems changes to deliver quality service to internal and external customers
Lead projects for the division from inception to completion
Facilitate change in VSP processes, procedures and systems within the business unit. Develop and implement communication strategies that support VSP and the division Mission, Vision, Value and Goals
Prioritize, assign and distribute work to ensure responsibility is at the appropriate level and team member's skills are developed to support business needs
Requirements
Job Specifications
Typically has the following skills or abilities:

• Bachelor's degree in related field or equivalent experience
• Minimum of 3 years of management experience with responsibilities for hiring, training, assigning work and managing performance of direct reports
• Intensive attention to detail
• Knowledge of quality performance monitoring and improvement methods
• Demonstrated ability to analyze work processes and implement changes in logical and efficient manner
• Excellent written and verbal communication skills including ability to communicate ideas in both technical and user-friendly language
• Strong organizational and project management skills including being self-motivated and directed
• Proficient with word processing and spreadsheet applications including experience in importing data for use in report software, spreadsheets, graphs, and flow charts
• Excellent analytical, mathematical, and creative problem-solving skills including ability to conduct research into systems issues and workflows as required
• Knowledge of claims adjudication, benefits setup, and contractual interpretation
• Experience in application configuration activities in a Healthcare environment
• Claims processes and knowledge of medical coding structures is preferred
• Strong ability to effectively prioritize and execute tasks in a high-pressure environment
• Experience working in a team-oriented, collaborative environment

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Salary Description
$86,000 - $92,000