Business Process Manager, Finance Operations

Health Plans Inc

9h•Onsite

About The Position

At HPI, we are a forward-thinking, national third-party administrator (TPA) specializing in self-funded health plan solutions. With over 44 years of industry expertise, our entrepreneurial spirit, flexible approach, and personalized service have empowered us to serve clients of all sizes across diverse industries. We deliver innovative strategies that maximize the value of every healthcare dollar. The self-funded health plan landscape is constantly evolving. At HPI, our partners benefit from having a TPA with the expertise, resources, and creativity to deliver customized plan solutions that help them win and retain more business. We excel at driving costs down and managing risk, while enhancing our clients’ employees’ health insurance experience. Our goal is to help members clearly understand their health plan and provide responsive service, enabling them to fully utilize their benefits and achieve greater health. Our commitment extends beyond our clients to our own employees. We foster a supportive and inclusive work environment where innovation thrives. By investing in our team’s growth and well-being, we ensure they are equipped to provide exceptional service.

Requirements

Bachelor’s degree in Business, Finance, Operations, or related field OR equivalent work experience.
3-5 years of experience in claims funding, self-funded health plans, finance operations, or a related role within a TPA, carrier, or benefits administration environment.
Strong understanding of self‑funded health plans, claims adjudication, and TPA workflows.
Working knowledge of banking processes, ACH funding, reconciliation, and payment file management.
Experience with cross‑functional process management and issue resolution.
Excellent problem‑solving, analytical, and organizational skills.
Strong communication skills, including ability to translate technical workflows for diverse audiences.
Work within specified timeframe and meet deadlines.
Strong customer service orientation and ability to build relationships.
Risk awareness and escalation judgment
Demonstrated commitment to maintaining confidentiality and ethical practice.
Proficient in Microsoft Office, including Word, Excel, Outlook, and PowerPoint.

Nice To Haves

Experience managing or designing workflows in a TPA or health plan environment.
Experience supporting self‑funded health plans and employer‑funded claim payment models.
Background in automation, workflow mapping, or operational optimization.
Familiarity with trend analysis, root cause analysis, or operational optimization initiatives.
Proficiency with claims administration systems (Javelina) and financial tracking tools
Experience with process improvement methodologies and workflow mapping tools (Lean, Six Sigma, etc.).
Client‑focused problem solving

Responsibilities

Lead and mentor the financial operations team responsible for day-to-day execution
Analyze current workflows, identify inefficiencies, and drive process improvements and automation.
Champion a culture of continuous improvement, operational discipline, and risk‑aware decision making.
Evaluate procedural gaps and implement solutions that reduce errors, delays, and financial risk.
Maintain documentation, SOPs and training materials for all assigned workflows.
Direct high‑volume provider and vendor disbursement workflows, including check issuance, EFT processing, and payment file validation.
Act as the subject matter expert and relationship lead for external payment vendor partners
Ensure payment timeliness and accuracy by maintaining strong internal controls and quality checkpoints.
Oversee root‑cause investigations for payment errors, bank rejects, vendor file issues, and reconciliation variances.
Partner with IT and Finance to optimize payment platforms, banking integrations, delivery of EOB(s), and reconciliation processes.
Act as a subject matter expert for financial operations within the claims ecosystem.
Participate in system upgrades, platform transitions, vendor evaluations, and strategic enterprise projects.
Support internal and external audits, including documentation requests, testing, and remediation planning.
Prepare and present performance reports to senior leadership.
Monitor workflow KPIs, turnaround times, exceptions, and error trends.
Perform root‑cause analysis to identify systemic issues and lead corrective action planning.
Provide reporting insights to leadership, highlighting risk areas and performance opportunities.
Lead or contribute to operational enhancement initiatives and system upgrades impacting financial workflows.