Manager, Claims Operations at HMA

| Seattle
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HMA is one of the nation's largest administrators of high-quality, innovative, and affordable health plans and distinctive services for self-funded organizations. Employers trust HMA's team of caring experts to protect two of their most important assets; their people and their health plan dollars. In 2021, HMA was chosen as a Washington's Best Workplaces by our Staff and PSBJ™, and in 2022 we were awarded one of Seattle's Best Places to Work by BuiltIn. Our vision, 'Proving What's Possible in Healthcare®,' and our values, People First!, Be Extraordinary, Work Courageously, Own It, and Win Together, shape our culture, influence our decisions, and drive our results.What we are looking for: We are looking to hire people that care deeply about others, thrive in evolving environments, gain satisfaction from being part of a team and helping others succeed, are motivated by tackling complex challenges, are courageous enough to share ideas, are action-oriented, are resilient, and are results-driven. What you can expect: You can expect an inclusive, flexible, and fun culture, comprehensive salary, benefits, and time off packages with plenty of personal development and growth opportunities. If you are looking for meaningful work, a clear purpose, high standards, work/life balance, and the ability to contribute to something important, find out more about us at: https://www.accesshma.com/How YOU will make a Difference: The Claims Operations manager is responsible for managing the HMA Claims Operations staff and their daily work requirements. Leveraging metrics and forecasts; they prioritize work load and resourcing to maximize operational production in partnership with vendor resources and liaisons.What YOU will do:
  • Direct supervisory responsibilities: Manages and coaches individual contributor's performance and quality.
  • Assess and manages claims inventory: Tracks and manages inventory trends and proactively adjusts resource levers as needed to maximize productivity
  • Oversees inventory: Tracks claims inventory trends and proactively guides the team to adjust as needed to maximize productivity
  • Create daily updates for management team flagging production rates, critical issues and areas of escalation in real time
  • Solutions oriented: Analyzes data, proactively assesses business needs, and adjusts resourcing levels to provide the best customer service while practicing fiscal responsibility.
  • Vendor auditing &QA: Leads vendor audits and manages reporting to ensure vendor quality.
  • Apply subject matter expertise to the business of claims processing and operations
  • Manage to vendor agreements, proactively identify and flag issues, escalate appropriately
  • Independently identify and resolve team issues with appropriate escalation for corporate wide impacts
  • Train and coach staff and vendors on claims processes as needed
  • Motivate talent: Ability to motivate and lead team members and vendors in accordance with HMA values and objectives
  • Talent planning: Proactively review and assess talent.
  • Continually develop and/or recruit talent to meet objectives
Knowledge, Experience, and Key Attributes needed for Success:
  • Bachelor's Degree or equivalent work experience
  • Minimum 5 years' of claims processing experience
  • Minimum 2 years' of people leading experience
  • Proven ability to manage and develop a team of highly skilled staff
  • Proven ability to manage and interact with vendors to support execution of work within the SLA's established
How we Support your Work, Life, and Wellness Goals:We offer a comprehensive total rewards package including: competitive pay; annual incentive; medical, dental, and vision insurance; 401K retirement plan with match; generous PTO and holidays; an onsite gym facility; a gym subsidy; Life, AD&D, Short-Term and Long-Term Disability Insurances; an Employee Assistance Plan; year-round wellness activities; the ability to earn a $500 wellness incentive; monthly events; paid volunteer hours and more! For local employees- free parking and easy freeway access to I-405 and I-520 and a well-stocked kitchen on-site with subsidized snacks and refreshments.HMA requires a background screen prior to employment.Protected Health Information (PHI) Access Healthcare Management Administrators (HMA) employees may encounter protected health
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Technology we use

  • Engineering
    • .NETLanguages
    • C#Languages
    • JavaLanguages
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    • PerlLanguages
    • PHPLanguages
    • PythonLanguages
    • RLanguages
    • SqlLanguages
    • jQueryLibraries
    • jQuery UILibraries
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    • ReactLibraries
    • AngularJSFrameworks
    • ASP.NETFrameworks
    • Backbone.jsFrameworks
    • AccessDatabases
    • Microsoft SQL ServerDatabases
    • MongoDBDatabases
    • MySQLDatabases
    • RedisDatabases

Location

HMA is located on the I-405 and I-520 corridors with free parking and bus access. We are near downtown Kirkland and Bellevue for happy hours & lunch.

An Insider's view of HMA

How would you describe the company’s work-life balance?

I absolutely love working at HMA because we put people first by bringing a human touch to the health insurance experience by providing direct communication with our Care Team! In addition, HMA fully supports a work/life balance, so the company supports us while we support our members! It's a win for all!

Vonda

Care Manager

What makes someone successful on your team?

One of the greatest things about the HMA culture is it gives me the opportunity to improve current processes and tasks. In addition, our culture encourages ideas and proactivity. This enables me to be fearless in creating various passion projects. Most importantly, the people I work with are very encouraging, collaborative, and friendly.

Isaac

Data Analyst

How do you make yourself accessible to the rest of the team?

I'm happy with the overall vibe of leader communications at HMA. Our leaders offer lots of opportunities to ask questions & don't shy (away) from hard topics.

HMA Team Member

IT Team

How do your team's ideas influence the company's direction?

I feel I can go to any People Leader and talk to them about a concern I may have. I feel supported and confident our Executive Leadership is taking HMA in the right direction. I truly appreciate how quickly HMA responded in the beginning of the COVID-19 crisis, keeping our personal safety at the forefront, above all else!!

HMA Team Member

Client Success Team

What are HMA Perks + Benefits

Culture
Volunteer in local community
We are thrilled to offer 1 paid day each year, for you to volunteer at a 501(c)(3) organization of your choice. In addition, we match your 501(c)(3) donations up to $1,000 every year.
Partners with Nonprofits
We partner with Bloodworks NW, Hopelink, and others to support our communities.
Friends outside of work
Eat lunch together
Intracompany committees
HMA has an activities committee to help us plan and coordinate fun events, a roundtable to discuss current topics, and a culture club to help plan company improvements.
Daily sync
Open door policy
Team owned deliverables
Team based strategic planning
Group brainstorming sessions
Open office floor plan
Diversity
Unconscious bias training
Hiring Practices that Promote Diversity
We actively recruit a diverse candidate pool and create a respectful culture celebrating uniqueness through education.
Health Insurance & Wellness Benefits
Flexible Spending Account (FSA)
Disability Insurance
Dental Benefits
Vision Benefits
Health Insurance Benefits
Life Insurance
Wellness Programs
Onsite Gym
Mental Health Benefits
Retirement & Stock Options Benefits
401(K)
401(K) Matching
Performance Bonus
Match charitable contributions
Child Care & Parental Leave Benefits
Flexible Work Schedule
Remote Work Program
Family Medical Leave
Return-to-work program post parental leave
Company sponsored family events
Vacation & Time Off Benefits
Generous PTO
Paid Volunteer Time
Paid Holidays
Paid Sick Days
Perks & Discounts
Beer on Tap
Casual Dress
Company Outings
Stocked Kitchen
Some Meals Provided
Happy Hours
Parking
Recreational Clubs
Fitness Subsidies
Home Office Stipend for Remote Employees
Professional Development Benefits
Lunch and learns
Cross functional training encouraged
Promote from within
Online course subscriptions available

Additional Perks + Benefits

HMA offers multiple continuous learning opportunities via Lunch 'n' Learns (industry education) and unlimited access to GO1.com, our learning platform where you can brush up on your technical expertise, learn soft skills, or build your leadership skills, to further your career. Also, for 2021, we are offering training in Fierce Conversation Foundations to every Staff member. We train all of our Leaders in Situational Leadership II and encourage a coaching and development culture across the organization.

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