Staff VP Claims Operations (Post Pay)
Elevance Health

Job Info

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Staff VP Claims Operations (Post Pay)

Location

Successful candidate must reside within 50 miles of an Elevance office, and able to work a hybrid schedule (3 days in office)

Summary

Responsible for the strategic and operational business needs of the Government Business and Commercial Division to include post-pay claims adjudication, payment disputes, and adjustments that meets all compliance and regulatory requirements.

Team Scope

7 direct reports / ~1000 FTE's

Position Responsibilities

• Oversees multiple claims processing units, executes strategies to deliver industry leading service results.
  
• Improves processes and partners across lines of business to develop consistency and share best practices.
  
• Drives results to improve member/provider satisfaction.
  
• Builds strong partnerships with Plan Presidents, collaborates with IT, Enterprise Benefit Administration, Provider Engagement and Contracting, Sales, and Internal Audit.
  
• Manages special projects and oversees budget.
  
• Hires, trains, coaches, counsels, and evaluates performance of direct reports.
  

Position Requirements

Requires a BA/BS in business administration or a related field and a minimum of 10 + years of management experience in claims that includes adjustments in the managed care and/or insurance industry, experience driving AI/RPA initiatives and transformations; or any combination of education and experience which would provide an equivalent background. MBA preferred.

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