Assistant Director Claims Production

Cambia Health Solutions

8d • Hybrid

About The Position

Assistant Director Claims Production Oregon, Washington, Idaho or Utah- Hybrid (in office 3 days a week) Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system. Who We Are Looking For: Every day, Cambia’s dedicated team is living our mission to make health care easier and lives better. As a member of the Payment Integrity team, our Assistant Director Claims Production provides leadership for Claims production processing activities in the commercial claims service organization and is responsible for strengthening the organization’s effectiveness in claims processing by achieving satisfaction through fast and accurate claims processing – all in service of creating a person-focused health care experience. As a people leader, you are willing to learn and grow, understanding that leadership is a craft that is continuously honed as you support your team and the lives that depend upon us. Are you a proven health plan operations leader? Do you pride yourself in developing and mentoring high performance teams? Then this role may be the perfect fit. Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care. Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through. Everyone is a health care consumer deserving of a simpler, more personalized experience. Cambia is transforming the health care system to revolve around people. For over 100 years we’ve designed people-first health solutions rooted in the nation’s first health plan, a loggers’ wage pool established in the Pacific Northwest. Today that pioneering spirit aligns our family of over 20 companies, including 4 not-for-profit BlueCross and BlueShield licensed health plans serving over 3 million Americans. Cambia blends data science with a compassionate human perspective to anticipate people’s needs, and empower them to make smarter health care choices. Interested in driving accessibility, affordability and quality health care for real people? Apply to any of our open jobs or join the Twitter conversation @Cambia. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.

Requirements

• Bachelor’s degree in business management, health care administration or another related field.
• 5 years management/supervisory experience with at least 3 years in claims processing, customer service or membership/enrollment or an equivalent combination of education and job-related work experience.
• Expertise regarding health plan legislation and regulations.
• Successful experience leading health plan operations such as membership, claims customer service and analytics & reporting.
• Ability to create, execute and evaluate short- and long-term operating plans.
• Business acumen including financial/budget management, data analysis and decision making.
• Demonstrated ability to manage managers and lead high performing teams.
• Ability to effectively delegate, evaluate performance, and to motivate and develop others across multiple functions.
• Proven competency in developing and maintaining effective relationships at all levels inside and outside of the organization.
• Excellent verbal and written communication skills including ability to effectively convey complex or sensitive issues or regulations.

Nice To Haves

• Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired.

Responsibilities

• Works cooperatively with executives and management teams throughout Cambia to accomplish goals.
• Maintains a leadership team approach to resolve problems or issues of overall importance.
• Matters that cross functional lines directly involve the position's input and may require frequent, direct contact and close communications with all levels across Cambia.
• Drives the effectiveness of the Claims organization through appropriate organizational structure, an effective work environment, regular employee communication, recognition and development.
• Continually strives toward increased customer satisfaction while increasing operational efficiency. This is accomplished through motivating all claims staff toward increased productivity, increased accuracy and focus on customer satisfaction.
• Responsible for fiscal management, including budget preparation, expenditure control, and record keeping.
• Strengthens the organization’s effectiveness in achieving customer satisfaction by ensuring fast and accurate claims processing.
• Coordinates with the directors from all Regence Plans to continuously improve the cost, quality and effectiveness of Operations functions.
• Oversees the selection, training, organization and proper compensation of Cambia claims employees.
• Creates and manages appropriate employee incentives and recognition.
• Partners with the Business Workforce Optimization teams to successfully implement new procedures and enhancements to claims systems that benefit our members.
• Directs the development of Cambia claims processing functions to contribute to improved productivity and accuracy in benefit application and reduced operating costs.
• As a member of our strong leadership community, you will provide direction to your team, engage them towards common goals and create a positive experience that helps people flourish.

Benefits

• Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits.
• Annual employer contribution to a health savings account.
• Generous paid time off varying by role and tenure in addition to 10 company-paid holidays.
• Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period).
• Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave).
• Award-winning wellness programs that reward you for participation.
• Employee Assistance Fund for those in need.
• Commute and parking benefits.

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Number of Employees: 5,001-10,000 employees