Accenture
Health Payer Operations Associate Director
Accenture, Miami, Florida, us, 33222
Accenture is a leading global professional services company that helps the world’s leading businesses, governments and other organizations build their digital core, optimize their operations, accelerate revenue growth and enhance citizen services—creating tangible value at speed and scale. We are a talent- and innovation-led company with approximately 750,000 people serving clients in more than 120 countries. Technology is at the core of change today, and we are one of the world’s leaders in helping drive that change, with strong ecosystem relationships.
As a Health Payer Operations Associate Director, your primary responsibilities may include:
Leading Transformational Change:
Lead process improvement initiatives across benefits, membership, claims and provider operations, implementing data-driven solutions to enhance efficiency and effectiveness. Claims Operations Improvement:
Lead and manage projects to improve claims processing efficiency and accuracy, ensuring timely and accurate processing while maintaining a focus on cost efficiency. Provider/Network Operations Improvement:
Oversee projects aimed at optimizing provider network operations, with a focus on enhancing provider onboarding, credentialing, contracting, and ensuring directory accuracy. Team Leadership and Collaboration:
Collaborate with client teams, including IT, compliance, and customer service, to ensure alignment of operations with broader organizational priorities and objectives. Compliance & Risk Management:
Stay up to date with evolving healthcare regulations and payer policies to ensure ongoing compliance within claims operations and network management. Here’s what you need: Bachelor’s degree in Healthcare Administration, Business, or related field. Minimum of 10 years of experience in healthcare consulting or enterprise operations improvement, with a focus on payer operations, claims processing, and/or provider network operations. Minimum of 10 years of experience leading transformation initiatives, streamlining processes, and implementing data-driven solutions. Minimum of 10 years of experience working with senior leaders and cross-functionally to achieve objectives, demonstrating excellent interpersonal and communication skills. Minimum of 10 years of experience in data analysis, operational metrics, and working with relevant software/tools (e.g., claims management systems, data visualization platforms). Minimum of 10 years of experience working independently and collaboratively in a fast-paced, client-focused environment. Bonus points if: Master's degree preferred. Experience working with or leading global teams. Exceptional problem-solving and analytical skills. Excellent communication and presentation abilities. Leadership experience, including team management and project oversight. Familiarity with reimbursement innovation, value-based care models and payer-provider alignment strategies. What’s in it for you? You will be part of a diverse, vibrant, global Accenture community; teams pushing the boundaries of new business capabilities and emerging technologies and services, sharing their experiences and lessons learned with each other. At Accenture, you will be able to work on meaningful and innovative projects, powered by the latest technologies and industry best practices. Accenture will continually invest in your learning and growth. You'll learn from and work with Accenture’s certified practitioners and Accenture will support you in growing your own tech stack, sales skills, and certifications. Compensation at Accenture varies depending on a wide array of factors, which may include but are not limited to the specific office location, role, skill set, and level of experience. Accenture is an Equal Opportunity Employer. We believe that no one should be discriminated against because of their differences, such as age, disability, ethnicity, gender, gender identity and expression, religion or sexual orientation.
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Lead process improvement initiatives across benefits, membership, claims and provider operations, implementing data-driven solutions to enhance efficiency and effectiveness. Claims Operations Improvement:
Lead and manage projects to improve claims processing efficiency and accuracy, ensuring timely and accurate processing while maintaining a focus on cost efficiency. Provider/Network Operations Improvement:
Oversee projects aimed at optimizing provider network operations, with a focus on enhancing provider onboarding, credentialing, contracting, and ensuring directory accuracy. Team Leadership and Collaboration:
Collaborate with client teams, including IT, compliance, and customer service, to ensure alignment of operations with broader organizational priorities and objectives. Compliance & Risk Management:
Stay up to date with evolving healthcare regulations and payer policies to ensure ongoing compliance within claims operations and network management. Here’s what you need: Bachelor’s degree in Healthcare Administration, Business, or related field. Minimum of 10 years of experience in healthcare consulting or enterprise operations improvement, with a focus on payer operations, claims processing, and/or provider network operations. Minimum of 10 years of experience leading transformation initiatives, streamlining processes, and implementing data-driven solutions. Minimum of 10 years of experience working with senior leaders and cross-functionally to achieve objectives, demonstrating excellent interpersonal and communication skills. Minimum of 10 years of experience in data analysis, operational metrics, and working with relevant software/tools (e.g., claims management systems, data visualization platforms). Minimum of 10 years of experience working independently and collaboratively in a fast-paced, client-focused environment. Bonus points if: Master's degree preferred. Experience working with or leading global teams. Exceptional problem-solving and analytical skills. Excellent communication and presentation abilities. Leadership experience, including team management and project oversight. Familiarity with reimbursement innovation, value-based care models and payer-provider alignment strategies. What’s in it for you? You will be part of a diverse, vibrant, global Accenture community; teams pushing the boundaries of new business capabilities and emerging technologies and services, sharing their experiences and lessons learned with each other. At Accenture, you will be able to work on meaningful and innovative projects, powered by the latest technologies and industry best practices. Accenture will continually invest in your learning and growth. You'll learn from and work with Accenture’s certified practitioners and Accenture will support you in growing your own tech stack, sales skills, and certifications. Compensation at Accenture varies depending on a wide array of factors, which may include but are not limited to the specific office location, role, skill set, and level of experience. Accenture is an Equal Opportunity Employer. We believe that no one should be discriminated against because of their differences, such as age, disability, ethnicity, gender, gender identity and expression, religion or sexual orientation.
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