Staff Vice President Commercial Government Claims - Medicare, Medicaid
Company: Top Echelon
Location: Virginia Beach
Posted on: November 18, 2021
Health Insurance / Payer at larger competitorsRelocation
assistance available. Responsible for developing the claims payment
and adjustment strategy in Government Business Division Claim
Operations. Primary duties may include but are not limited to:.
Leads 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 provider satisfaction..
Builds strong partnerships with Plan Presidents, collaborates with
IT, Enterprise Benefit Administration, Provider Services, Quality
and Internal Audit.. Leads systems consolidation efforts,
compliance requirements, and monitors state/federal regulations..
Manages special projects and budget oversight.. Hires, trains,
coaches, counsels, and evaluates performance of direct reports..
Requirements. Requires a BA/BS in business administration or a
related field; 10 + years of management experience in claims that
includes adjustments in the managed care and/or insurance industry;
or any combination of education and experience, which would provide
an equivalent background. MBA preferred.. Hiring Managers preferred
skillset & experience. IDEAL EXPERIENCE. Government - Medicaid
and/or Medicare. Transaction Operations, Claims preferred.
Leadership Depth and Breadth. Oversight of vender relationships and
operations transition experience preferred. Focused on metric
driven results, identifies and analyzes problems using facts and
data to leverage resources available and solve problems
creatively.. Formulates objectives and priorities. Implements plans
consistent with the long-term interest of the business unit and
organization. Capitalizes on opportunities and manages risks..
Develops new insights into situations; questions conventional
approaches; encourages new ideas and innovations.. Builds a shared
vision with others; acts as a catalyst for organization change.
Influences others to translate vision into action.. Expresses ideas
clearly and uses language to build common understanding. Works
across the organization to build collaborative relationships..
Resourceful; overcomes obstacles. Aligns resources to accomplish
key objectives and assigns clear accountability for important
objectives.. Inspires and motivates others to take action.. Fosters
an inclusive workplace where diversity and individual differences
are valued and leveraged to achieve the vision and mission of the
organizationPosition descriptionPotential Location: Mason Ohio,
Virginia Beach, VA & Tampa, FLPosition: Staff Vice President
Commercial Government Claims - Medicare, Medicaid
Keywords: Top Echelon, Virginia Beach , Staff Vice President Commercial Government Claims - Medicare, Medicaid, Executive , Virginia Beach, Virginia
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