Description
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We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply!
Our people make all the difference in our success.
The Health Claims Administration (HCA) Manager leads a team of Health Claims Processors and Claims Clerks. The HCA Manager is responsible for the day-to-day leadership of the team providing strategic direction and ownership for managing performance, workflow management, departmental priorities and client service delivery.
The HCA Manager collaborates with the Health Claims Administration Leadership Team to provide tactical plans for executing resource deployment strategies, a balanced and level workflow, and output expectations based upon demand and capacity analysis on a daily, weekly, and monthly basis. Monitors the day-to-day workflow and in collaboration with the Leadership Team, makes real time and future recommendations to scheduling practices to ensure cost and service level goal attainment. This role is responsible to have a constant pulse on the teams’ inventory of tasks to be completed and how they relate to internal and external service standards.
Key Responsibilities:
Lead and develop a highly performing team by establishing clear goals and objectives and team accountability expectations, while managing and leading change
Identify opportunities for improvement and guide team members in achieving their business and personal goals
Ensures the external and internal service delivery standards and quality measures are achieved
Provide oversight to the end-to-end claims processing activities and support on various assignments/projects
Handle escalations for high priority items to ensure departmental deliverables are met
Design or optimize resource planning tools
Conducts resource planning quantitative analysis, predictive modeling and forecasting
Oversee the distribution of the work assignments, including long-term schedules, ensuring cost and service level goal attainment
Overseeing the time off planning of the team, maintaining budget allotment and impact to service levels
Analyze claim volume trends to predict staffing needs and ensure the more efficient and productive allocation of resources
Collaborate with the Leadership Team to stay up-to-date on flex resource requirements
Generate reports on trends, productivity, quality and service levels
Develop and oversee the implementation of procedures within the department ensuring they align with the department goals and objectives
Identify areas of improvement and oversee the implementation of strategies for enhancing process efficiencies
Oversee systems testing and UATs in coordination with other members of the HCA leadership team
Participate in annual Disaster Recovery and Business Continuity Exercises
Special projects as required which require understanding of broader business
Qualifications:
Post-secondary degree or diploma
3+ years of leadership experience
3-5 years of experience in an analytical/workforce/scheduling role
Understanding of industry standard metrics and real time reporting tools
Ability to work cross-functionally to proactively communicate and influence key stakeholders at all levels of an organization to resolve issues with the highest sense of urgency
Ability to motivate and influence team members, and create a culture that supports high engagement
Embodies a passion for excellence, instilling shared values for team success
Strong analytical and critical thinking skills
Advanced problem-solving skills and the ability to work collaboratively with other teams to resolve complex issues
Ability to manage multiple lines of business with varying service level requirements
Excellent verbal and written communication skills
Exceptional problem-solving skills
Ability to work effectively within a team and independently
Knowledge of computer applications (MS Office, Excel, Access and PowerPoint)
*Internal application deadline: February 7, 2025*
Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link.
