Excellus Health Plan Inc.
Director Claims Performance & Optimization 000792 (Administrative)
Summary:
Under the guidance of Claims senior leadership, this position is responsible for executing on Operational Excellence performance goals by developing and leading the analytical process improvement and optimization teams responsible for participating in and leading continuous improvement initiatives designed to improve operational, process and system excellence. The Director balances strategic vision with day-to-day execution regarding root cause analysis, leading continuous improvement efforts, responding to inquiries from providers and employer groups, researching complex claim problems, and developing solutions for all processing systems. This position is responsible for creating and managing business plans consistent with the Health Plan strategic goals for Local, Blue Card, Dental, FEP claims processing and inquiry functions for the health plan. This includes but not limited to inventory management, process development/ improvement and internal and external communications at all staff and leadership levels to ensure desired outcomes are achieved.
Essential Responsibilities/Accountabilities:
Minimum Qualifications:
Physical Requirements:
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The Lifetime Healthcare Companies aims to attract the best talent from diverse socioeconomic, cultural and experiential backgrounds, to diversify our workforce and best reflect the communities we serve.
Our mission is to foster an environment where diversity and inclusion are explicitly recognized as fundamental parts of our organizational culture. We believe that diversity of thought and background drives innovation which enables us to provide leading-edge healthcare insurance and services. With that mission in mind, we recruit the best candidates from all communities, to diversify and strengthen our workforce.
OUR COMPANY CULTURE:
Employees are united by our Lifetime Way Values & Behaviors that include compassion, pride, excellence, innovation and having fun! We aim to be an employer of choice by valuing workforce diversity, innovative thinking, employee development, and by offering competitive compensation and benefits.
In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.
Equal Opportunity Employer
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)
Director