Claims Processing Sr Manager

Kaiser Permanente   •  

Rancho Cucamonga, CA

Industry: Hospitals & Medical Centers

  •  

8 - 10 years

Posted 33 days ago

Description:


Responsible for the operations of one or more claims processing units, including timely and proper adjudication of claims in accordance with contractual benefits. Responsible for providing leadership and direction to employees. Directs the processing of insurance claims to meet operation, financial, and service requirements. Develops and executes strategic and operational business plans for the departments. Coordinates department operations and modifications with other areas of the organization.


Essential Responsibilities:


Establishes operational objectives and work plans, and delegates assignments to subordinate managers.

Establishes and assures adherence to budgets, schedules, work plans, and performance requirements.

Participates in the long-term strategic planning and direction setting of the function.

Develops and establishes operational policies within area managed.

Involved in developing, modifying and executing company policies that affect immediate operations and may also have KP-wide effect.



Participates in the development of overall functional objectives and KP goals.



Basic Qualifications:


Experience


Minimum eight (8) years of experience in a claims processing or related environment with five (5) years of management experience.


Education




Bachelor's degree in business administration, OR four (4) years of experience in a directly related field.




High School Diploma or General Education Development (GED) required.


License, Certification, Registration


N/A


Additional Requirements:


Experience in managing large groups of employees in a collaborative work team environment required.

Requires advanced knowledge of claims processing and working knowledge of multiple related functions.


Preferred Qualifications:


Master's degree preferred.



Primary Location: California,Rancho Cucamonga,Empire Corporate Plaza 10740 4th St.

Scheduled Weekly Hours: 40

Shift: Day

Workdays: Mon, Tue, Wed, Thu, Fri

Working Hours Start: 8:00 AM

Working Hours End: 5:00 PM

Job Schedule: Full-time

Job Type: Standard

Employee Status: Regular

Employee Group/Union Affiliation: Salaried, Non-Union, Exempt

Job Level: Director/Senior Director

Job Category: Insurance / Claims

Department: NCA-PDMC-ISS-COOL

Travel: Yes, 5 % of the Time Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.


External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.