United States onlyAt Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders – internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity and empower each other to illuminate our collective potential.
Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!!
JOB SUMMARY: This position leads, plans, develops and directs all aspects of respective cost centers, functions and/or processes within the MRA (Medical Reimbursement Analysis) department. In addition, this position regularly partners with senior management to define and execute short- and long-term business goals to grow the business and ensure operating efficiencies. JOB ROLES AND RESPONSIBILITIES:1. Direct the daily operations of assigned business units, to ensure consistent delivery of quality results, operational efficiency and attainment of expectations set forth by internal and external clients. Complete analysis to drive effective problem solving and innovation to processes to include business process re-engineering, automated solutions and overall product and service excellence.
2. Provide leadership for multiple sites across the department through real time management and mid & long range forecasting. Support and align succession planning and business strategy.
3. Establish, implement and maintain departmental performance standards and strategic planning in support of compliance, service and savings to maximize all opportunities to strengthen the customer experience
4. Manage execution of the MRA (DIS) Services objectives through team members in a timely, cost-effective manner.
5. Develop and maintain strong relationships both internally and externally, including but not limited to open communication amongst all departments within the organization to ensure company and department goals are consistently met.
6. Develop and maintain action plans and processes to monitor and improve retained savings based on requirements outlined by the primary client and other payer clients
7. Oversee execution and completion of complex service and claims issues, resolving them timely, effectively and with minimal supervision.
8. Direct the budget process and financial planning for the assigned cost centers and assure adherence to the budget plan and balance cost containment with department needs and customer satisfaction as a high priority.
9. Serve as business sponsor for Agile application development projects and other associated client implementation initiatives or related business projects driving improved performance, processes and quality
10. Participate in active dialogue with sales, account management and regulatory on a scheduled basis in support of the existing and proposed product portfolio.
11. Select, develop, and evaluate staff to ensure the efficient operation of department.
12. Collaborate, coordinate, and communicate across disciplines and departments.
13. Ensure compliance with HIPAA regulations and requirements.
14. Demonstrate Company's Core Competencies and values held within.
15. Please note due to the exposure of PHI sensitive data -- this role is considered to be a High-Risk Role.
16. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary. JOB SCOPE:
This position is a key leadership role in the organization, supporting senior management, and has ownership over product performance. The role requires strong communication skills as well as the effective coordination of client requests to achieve outlined business goals. The incumbent works independently under minimal supervision and with considerable discretion to make decisions that affect the day-to-day operations of the department. The management of day-to-day operations focuses on operating decisions at the project or functional level of his/her assigned areas of responsibility. The incumbent uses an extensive range of knowledge to complete responsibilities, basing decisions on sound logic and rationale; choosing the best alternative based on consideration of pros, cons, tradeoffs, timing and available resources; and making decisions on problems and issues requiring immediate attention or are complex functional issues. This is a people management role with authority for hiring, discipline, performance management, coaching, mentoring, etc. QualificationsJOB REQUIREMENTS (Education, Experience, and Training): * Minimum bachelors' degree in a relevant field coupled with 10 years' experience in an operational management/leadership role at least 7 years' of which should be inclusive of experience within healthcare markets (i.e. insurance companies, TPA, HMO, or managed care).
* Required licensures, professional certifications, and/or Board certifications as applicable
* Knowledge of health care and managed care products
* Communication (written, verbal and listening), leadership, management, planning, directing, interpersonal, business acumen, analytical, negotiation, organization, and prioritzation skills
* Ability to elicit trust and credibility as well as interface with all levels of the organization
* Ability to build relationships with internal and external customers
* Ability to formulate the solution and involve others in solving issues
* Ability to be comfortable with and manage in-person client interface
* Ability to commit to highest standards of quality and integrity
* Ability to travel as needed
* Ability to use hardware, software, and peripherals related to job responsibilities including MS Office
* Abiiltiy to lead and mentor individuals and teams
* Ability to represent the company in a positive and professional manner
* Ability to perform multiple tasks simultaneously and adapt to changing priorities in a positive and professional manner
* Ability to maintain ongoing collaboration with counterparts in the organization to ensure appropriate operational support, coordination of objectives and strategic planning
* Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone
The salary range for this position is $149-175K. Specific offers take into account a candidate’s education, experience and skills, as well as the candidate’s work location and internal equity. This position is also eligible for health insurance, 401k and bonus opportunity.
BENEFITS
We realize that our employees are instrumental to our success, and we reward them accordingly with very competitive compensation and benefits packages, an incentive bonus program, as well as recognition and awards programs. Our work environment is friendly and supportive, and we offer flexible schedules whenever possible, as well as a wide range of live and web-based professional development and educational programs to prepare you for advancement opportunities.
Your benefits will include:
- Medical (PPO & HDHP), dental and vision coverage
- Pre-tax Savings Account (FSA & HSA)
- Life & Disability Insurance
- Paid Parental Leave
- 401(k) company match
- Employee Stock Purchase Plan
- Generous Paid Time Off – accrued based on years of service
- WA Candidates: the accrual rate is 4.61 hours every other week for the first two years of tenure before increasing with additional years of service
- 10 paid company holidays
- Tuition reimbursement
- Employee Assistance Program
- Sick time benefits – for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year, unless the laws of the state in which the employee is located provide for more generous sick time benefits
APPLICATION DEADLINE
We will generally accept applications for at least 5 calendar days from the posting date or as long as the job remains posted.
