Health Plans Inc
Vice President of Claims
Health Plans Inc, Westborough, Massachusetts, us, 01581
Health Plans, Inc. (HPI) is a New England-based Third Party Administrator (TPA) of self-funded health and benefit plans. HPI was founded in 1981 to provide comprehensive health plan administration to employers, municipalities and Taft-Hartley plans. Health Plans has grown to become an industry-leading TPA by offering customized self-funded benefit plans to employers, combined with superior customer service and investment in the latest administrative and data-mining technology, and reinsurance (stop-loss) security.
Summary:
The Vice President of Claims Operations oversees the Claims, Technical Resource Unit, Reinsurance, Enrollment, Billing & Payment Configuration, and Cobra areas of the business. The Vice President of Claims Operations also oversees the development of goals and employee bonus measures, and regularly tracks progress towards meeting those goals.
As a member of the senior leadership team of Health Plans, the Vice President is responsible for participating in strategic planning. The Vice President leads the advancement of these areas in terms of: regulatory compliance; effective and efficient operations; automation and adoption of cutting edge technology and practices.
Duties and Responsibilities (other duties may be assigned):
Oversees the assigned departments and ensures accurate and timely processing of appropriate activities
Participates in setting corporate strategy and direction
Identifies and directs activities related to process improvement and automation for responsible functions
Provides direct supervision of the Director of Claims & TRU, Director of Enrollment and COBRA operations and Director of Billing, Payment and Enrollment Configuration
Maintains current and thorough knowledge of Federal, State and local laws and regulations related to functional areas
Maintains current and thorough knowledge of accounting principles and practices to maximize compliance and revenue.
Education Requirements:
Bachelor’s Degree
Experience Requirements:
Ten or more years’ experience in health benefits and/or manage care industries with a track record of increasing management responsibilities
Ability to provide leadership in alignment with organizational goals
Ability to effectively coordinate external relationships
Communicates effectively, both verbally and in writing
Ability to work both independently and as a member of the management team
Ability to work within specified timeframes and meet deadlines
Recognize and maintain confidentiality of work materials as appropriate
Advanced proficiency in in Microsoft Office, including Word, Excel, Outlook and PowerPoint
Health Plans Inc. is an EEO – M/F/D/V employer
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Summary:
The Vice President of Claims Operations oversees the Claims, Technical Resource Unit, Reinsurance, Enrollment, Billing & Payment Configuration, and Cobra areas of the business. The Vice President of Claims Operations also oversees the development of goals and employee bonus measures, and regularly tracks progress towards meeting those goals.
As a member of the senior leadership team of Health Plans, the Vice President is responsible for participating in strategic planning. The Vice President leads the advancement of these areas in terms of: regulatory compliance; effective and efficient operations; automation and adoption of cutting edge technology and practices.
Duties and Responsibilities (other duties may be assigned):
Oversees the assigned departments and ensures accurate and timely processing of appropriate activities
Participates in setting corporate strategy and direction
Identifies and directs activities related to process improvement and automation for responsible functions
Provides direct supervision of the Director of Claims & TRU, Director of Enrollment and COBRA operations and Director of Billing, Payment and Enrollment Configuration
Maintains current and thorough knowledge of Federal, State and local laws and regulations related to functional areas
Maintains current and thorough knowledge of accounting principles and practices to maximize compliance and revenue.
Education Requirements:
Bachelor’s Degree
Experience Requirements:
Ten or more years’ experience in health benefits and/or manage care industries with a track record of increasing management responsibilities
Ability to provide leadership in alignment with organizational goals
Ability to effectively coordinate external relationships
Communicates effectively, both verbally and in writing
Ability to work both independently and as a member of the management team
Ability to work within specified timeframes and meet deadlines
Recognize and maintain confidentiality of work materials as appropriate
Advanced proficiency in in Microsoft Office, including Word, Excel, Outlook and PowerPoint
Health Plans Inc. is an EEO – M/F/D/V employer
#J-18808-Ljbffr