Sr. Director, Insurance Operations

Location: San Francisco, CA
Job title: Sr. Director, Insurance Operations
Location: San Francisco, CA
Direct hire position
 
This growing organization is reinventing health insurance through innovative business models, data  and analytics to provide personalized care. Join a mission-driven team working together to provide solutions in the complex area of healthcare.
The Insurance Operations teams are working to implement systems that help drive healthy outcomes. This position manages a growing team optimizing service delivery while meeting regulatory compliance.
 
Job description:
- Investigate operational gaps within claims processes and re-design inefficient workflows
- Collaborate with key stakeholders and departments, and design and execute programs to prevent fraud and waste
- Work cross-functionally to help build product and technology roadmaps, as the primary point of contact for payment integrity   
- Assess emerging claims trends and provide strategies for improved payment and insightful, detail-oriented reporting on those trends
- Build strong, high functioning teams and processes to support payment transparency, accuracy and integrity
 
Experience and Skills:
-Strong experience and interest in solving problems; you can dig into details and mentor your teams to do the same.
-Track record in visualizing how technology can enable better operational delivery and how to use data to make better decisions.
-Collaborative, enjoy mentoring and developing teams, and have strong written and verbal communication skills
-Understand compliance and protecting the privacy and rights of customers.
-Background in medical claims processing and adjustment, CMS rules and regulations in coding and billing compliance, payers and reimbursement
   
 
 
Warmest regards,
 
Aileen Bradley
Addastaff Consulting, Inc.
Senior Technical Recruiter
650-638-9633 x303

 
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