Manager, Claims Operations
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