Description
State of NH, Claims Manager
Location : Manchester, NH; Woburn, MA. This position will work a hybrid model (remote and office). The ideal candidate must live within 50 miles of the Elevance Health PulsePoint locations listed above.
The State of NH, Claims Manager oversees an operations unit(s); executes or supports strategies to deliver industry leading digitized service results. Partners across departmental lines to support further penetration of operational digitization, E2E efficiencies, lowered administrative costs and an excellent member and provider experience. Supports effective achievement of digital operations organizational objectives.
How you will make an impact:
- Plans, directs, and controls the resources and efforts of an operational unit within blended Digital Operations organization
- Supports objectives of the company and the blended Digital Ops organization
- Supports digitization initiatives by demonstrating understanding current operational business processes that digitization does/can enable
- Assists in budget development
- Serve as a functional expert and guide team members towards new ways of working and leveraging digital solutions
- Ensures compliance with state and federal regulations
- Participates with peers and digital operations leadership to deliver on tactical plans and objectives
- Provides direct, daily oversight of transactional operations staff, ensuring production levels and quality are maintained
- Monitors, on a daily basis, inventory levels, aging and quality and takes immediate corrective actions as needed
- Hires, trains, coaches and evaluates performance of direct reports
- Provides leadership in motivating subordinates to maintain high production and quality levels
- Provides quality control services by monitoring work results of direct reports
- Develops a strong team through training and effective organizational development practices.
- Manages processes and receives assignments in the form of objectives and framework on how to meet goals
- Manages resources (people, material, support) to get things accomplished within unit of responsibility
- Identifies and resolves hurdles for assigned area/group
- Leverage reporting and analytics tools, continually monitors procedures and operational metrics to ensure these are met by staff
- Manages across geographically diverse associates and vendor partners
- Builds strong partnerships with market and digital leads, Benefits Administration, Provider Engagement and Contracting, Sales and Internal Audit
- Effectively interfaces with external contacts, e.g. customers, vendors and agencies
Minimum Requirements:
Requires a BA/BS in Information Technology or Business Administration, 3+ years' of experience leading technology (application development, configuration, maintenance or implementation and support) teams and/or cross functional project (technology and operations) teams and a minimum of 2 years of management experience in managed care and/or health insurance industry; or any combination of education and experience which would provide an equivalent background.
Preferred Skills, Capabilities, and Experiences:
- 3+ years' experience leading claims teams in a large healthcare payor setting
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.comfor assistance.