Supervisor, Claim Adjudication Operations

🕒 Junho 11

🐻 Alaska, Hawaii, +11 estados a mais – Remoto

🐻 Alaska – Remote 🌺 Hawaii – Remote 🦞 Maine – Remote 🗻 New Hampshire – Remote 🌶️ New Mexico – Remote 🌾 North Dakota – Remote 🎸 Mississippi – Remote ⚓ Rhode Island – Remote 🌴 South Carolina – Remote 🗿 South Dakota – Remote ⚔️ Virginia – Remote ⛰️ West Virginia – Remote 🦬 Wyoming – Remote

💵 $63.927 - $76.900 / ano

⏰ Tempo Integral

🟡 Pleno

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⚙️ Operações

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Navitus Health Solutions

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

Fundada em 2003

⚕️ Seguro de Saúde

💊 Farmacêutico

🤝 B2B

Healthcare Insurance • Pharmaceuticals • B2B

Microsoft 365 é uma suíte de aplicativos de produtividade baseada em nuvem, desenvolvida para pessoas, famílias, empresas e instituições de ensino. Inclui ferramentas populares como Word, Excel, PowerPoint, Outlook e Teams, permitindo criar, colaborar e compartilhar documentos e dados de forma contínua entre dispositivos. O Microsoft 365 aumenta a produtividade com recursos como o Microsoft Copilot, que integra capacidades de IA para auxiliar nas tarefas do dia a dia, garantindo o armazenamento e a organização seguros dos arquivos e facilitando o trabalho em equipe e a comunicação eficaz.

Descrição

• Oversee roles within the Claim Adjudication Operations department to support accurate and timely configuration and data transfers of client hierarchy, benefits, and networks. • Provide superior customer service utilizing a high-touch, customer centric approach focused on collaboration and communication. • Outreach and collaborate with CAO customers/partners for day-to-day work and contribute to action plan creation. • Oversight of work on Kanban boards, meeting turnaround times and performance guarantees. • Run department Kanban board(s) and huddles, including sizing of work requests. • Resource assignment of day-to-day work, audits, and root cause analysis/CAP. • Perform 1:1s to elicit feedback from department associates, provide mentorship, discuss career development, address performance, and provide workload and project guidance. • Perform workforce management duties for direct reports, including, but not limited to, overtime needs, time out of the office and time tracking. • Apply soft skills toward team members and external stakeholders alike in understanding every point of view and coming to the table with good negotiation skills. • Must have the ability to work with different personalities across all departments and understand their point of view to communicate accordingly. • Adhere to department level objectives to ensure alignment with division and company strategic initiatives. • Participate in, adhere to and support compliance and diversity, equity, and inclusion program objectives. • Other duties as assigned.

🎯 Requisitos

• Bachelor’s degree or equivalent work experience is required. • 4 years of experience required. • Knowledge of one or more responsibilities as defined above is strongly preferred. • Professional PBM industry work experience is preferred. • Knowledge of applicable data privacy practices and laws is preferred. • Healthcare industry practices and HIPAA knowledge would be a plus. • Experience as a member of a multi-disciplinary team is a plus. • Understanding of human resource management principles, practices, and procedures would be a plus.

🏖️ Benefícios

• Top of the industry benefits for Health, Dental, and Vision insurance • 20 days paid time off • 4 weeks paid parental leave • 9 paid holidays • 401K company match of up to 5% - No vesting requirement • Adoption Assistance Program • Flexible Spending Account • Educational Assistance Plan and Professional Membership assistance • Referral Bonus Program – up to $750!