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SalaryJob Title:Manager of Claims Health Plans
Location: Corvallis, OR 97330
Duration: Permanent
Shift: Days , full time
Guaranteed hours a week: 40
Start: ASAP
Job ID: 267099
Hybrid position, will be onsite in Corvallis 2-3 times a week or more if needed. We need a candidate with strong management experience.
JOB SUMMARY/PURPOSE
Oversees and manages the client's Health Plans Claims Department. Is responsible for accurate and timely claims processing for all programs administered by Samaritan Health Plans. Provides oversight to staff and ensures that the organization's performance expectations, financial standards, and goals are achieved. Enhances department bench strength by hiring, coaching and mentoring direct reports. Responsible for the completion and success of all internal and external claims audits. Analyzes claims data and ensures compliance requirements are met.
DEPARTMENT DESCRIPTION
This facility operates a portfolio of health plan products under several different legal structures: Inter Community Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; client's Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for the client's Services’ self-funded employee health benefit plan. As part of an Integrated Delivery System, client's Health Plans is strategically and operationally aligned with Samaritan Health Services’ mission of Building Healthier Communities Together.
EXPERIENCE/EDUCATION/QUALIFICATIONS
- Bachelor's degree in healthcare or a related field, or equivalent direct claims experience required.
- Three (3) years management experience in a health plan claims department required.
- Experience or training in the following required:
- Collecting, analyzing and displaying statistical reports by computerized technology.
- Basic medical terminology.
- Medicare and/or Medicaid experience preferred.
KNOWLEDGE/SKILLS/ABILITIES:
- Leadership - Inspires, motivates, and guides others toward accomplishing goals. Achieves desired results through effective people management.
- Conflict resolution - Influences others to build consensus and gain cooperation. Proactively resolves conflicts in a positive and constructive manner.
- Critical thinking – Identifies complex problems. Involves key parties, gathers pertinent data and considers various options in decision making process. Develops, evaluates and implements effective solutions.
- Communication and team building – Leads effectively with excellent verbal and written communication. Delegates and initiates/manages cross-functional teams and multi-disciplinary projects
Should you be interested, let's discuss this briefly at your earliest convenience and please feel free to contact me at 703-652-7170, my name is Ailyn, I am available from Mon to Fri at 9a-6p EST.
Who We Are?
Since 2001 InfiCare has been providing contract and direct hire staffing services to its clients across the US.
Click below links to review some of the best workplace awards won by InfiCare:
https://www.greatplacetowork.com/certified-company/7037388 https://www.inc.com/profile/inficare
Job Type: Full-time
Pay: $73,000.00 - $110,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Work setting:
- In-person
Education:
- Bachelor's (Preferred)
Experience:
- management in a health plan claims department: 3 years (Required)
- medical terminology: 1 year (Preferred)
- Collecting, analyzing and displaying statistical reports: 1 year (Preferred)
- Medicare and/or Medicaid: 1 year (Preferred)
Work Location: In person
