Director II, Claims Ops Transformation

Elevance Health • Wallingford, IN

1d • Hybrid

About The Position

The Director II, Claims Ops Transformation oversees a combined digital and operations unit(s); executes strategies to deliver industry leading digitized service results. Serve as a leader across departmental lines in order to further penetration of operational digitization, E2E efficiencies, lowered administrative costs and an excellent member and provider experience.

Requirements

• Requires an BA/BS degree in Information Technology, Computer Science or related field of study and a minimum of 8 years experience leading technology (application development, configuration, maintenance or implementation and support) teams and/or cross functional project (technology and operations) teams; or any combination of education and experience which would provide an equivalent background.
• Requires 7 years' management experience.

Nice To Haves

• Proven experience leading large Claims Operations teams (100-200 employees) within a matrixed healthcare payer environment strongly preferred.
• Proven experience leading Claims Operations strategy strongly preferred.
• Digital literacy strongly preferred.
• Health insurance industry experience strongly preferred.
• Claims operational experience strongly preferred.
• Process Improvement/Six Sigma skillset preferred.

Responsibilities

• Lead digital transformation initiatives that improve claims operations and overall service delivery.
• Partner with leaders across the organization to implement strategic plans and shared goals.
• Leads overall strategic work streams for transformational priorities which requires significant accountability and management of numerous special projects.
• Plans, directs, and controls the resources and efforts within a blended Digital Claims Operations organization.
• Effectively manage the resolution of intra-organizational issues in the balanced best interests of the business.
• Executes objectives of the company and the blended Digital Ops organization
• Responsible & accountable for implementation / management of digitization initiatives that demonstrates understanding of current and future operational business processes that digitization does/can enable.
• Ensures compliance with state and federal regulations.
• Oversees strategic planning, budget development, and management for a single large or multiple cost centers, contract compliance, and any necessary integration of government regulatory requirements.
• Manages an enterprise suite of applications by developing digitization forecast and delivery plan.
• Ensures disaster recovery and business continuity plan are implemented, monitored, and updated on a recurring basis.
• Delivers operational guidance and offers system solutions that support the operations of their functional areas on a 24x7x365 basis.
• Plans and executes annual projects while maintaining profit and loss (P&L) responsibility.
• Develops a strong team through training and effective organizational development practices.
• Implements the policies, practices, and procedures of the company and blended digital and operations organizations.
• Manages direction of information system and programming activities of technical staff.
• Leveraging reporting and analytics tools, continually monitors procedures and operational metrics to ensure these are met by staff.
• Builds strong partnerships with market and digital leads, Benefits Administration, Provider Engagement and Contracting, Sales and Internal Audit.
• Hires, trains coaches, counsels, and evaluates performance of direct reports.

Benefits

• a comprehensive benefits package
• incentive and recognition programs
• equity stock purchase
• 401k contribution
• medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources

What This Job Offers

• Job Type: Full-time
• Career Level: Director