• Manager, Claims & Contract Support Services

    Job Locations US-WA-Tacoma
    ID
    2018-5195
    # of Openings
    1
  • Overview

    Position Purpose: Oversee the operation of the Contract Implementation Analyst and Claims Liaison teams 

    Responsibilities

    •  Oversee the claims operation function, including contracting and configuration
    • Monitor staff performance to identify any process or quality gaps and develop/implement business solutions to correct issues
    • Provide management with necessary data to expedite resolution of claims issues and support in policy decisions related to claims operations
    • Serve as the subject matter expert in resolution of claims and configuration issues
    • Manage the health plan’s workflow to assure timely, accurate submission and implementation of contracts
    • Act as health plan interface on software product upgrades/implementations that affect contract implementation
    • Promote change through establishment and sharing of best practices
    • Interface with all organizational levels to mobilize commitment and ensure accurate configuration, contract implementation, and claims operations

     

    Qualifications

    Education/Experience:

    • Bachelor’s degree in related field or equivalent experience. 
    • 5+ years of provider relations/services, provider contracting and/or claims administration experience in a managed care environment.
    • Experience with Medicare and Medicaid claims and contracting preferred.

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