Division VP, Healthcare COB and TPL Services Programs

Performant Financial   •  

Sunrise, FL

Industry: Accounting, Finance & Insurance


15+ years

Posted 52 days ago

This job is no longer available.

Responsibilities: The Healthcare Division VP of COB and TPL Services applies subject matter expertise in Commercial, State and Federal healthcare programs, specific to Coordination of Benefits (COB) and Third Party Liability TPL services, and provides leadership and strategic guidance to drive positive impact to the achievement of business objectives.

Essential Duties

• Collaborates internally to proactively support strategies and approaches to maximize efficiencies and effectiveness of operations and shared services
•Provides leadership and manages the daily operations of carrier billing and recovery, including both direct management of recovery teams and indirect management of matrixed shared services.
•Recruit, train, manage, develop and maintain skilled team members to execute upon COB and TPL processes
•Grow profitability through management of costs and delivery of strong recovery metrics
•Develop infrastructure and processes for other insurance eligibility discovery and validation
•Design and deliver process enhancements for carrier billing
•Develop and manage provider recovery processes, as appropriate
•Define and deliver regular reporting for both clients and internal stakeholders
•Solve both operational and strategic challenges through innovative, scalable and supportable solutions
•Motivate both direct reporting and matrixed teams to maintain daily performance and deliver industry-leading results
•Forecast accurate productivity and profitability metrics and manage teams to meet or exceed these metrics
•Provide regular reporting to management and peer stakeholders and effectively escalate risks and issues as appropriate
•Travel as required to meet business needs
•Other duties as assigned

Required Skills and Knowledge: •Proven operational and subject matter expertise in Commercial, State and Federal healthcare programs, Coordination of Benefits (COB) and Third Party Liability (TPL), as well as healthcare payer communities
•Expert operations leadership and operational management demonstrated through previous successful business results
•Demonstrated strength in applicable technologies and data analytics
•Strong verbal and written communication skills; ability to communicate, develop relationships and influence effectively at all levels both internally and key stakeholders
•Strong analytical and problem-solving skills; ability to analyze diverse information and use sound logic to develop solutions and approaches
•Demonstrated ability to collaborate and drive initiatives in a matrix organization structure in a positive and professional manner that aligns with Performant values and interests
• Strong project and program management skills
•Ability to deal well with ambiguity. Can effectively shift focus and priorities, as well as handle risk and adversity comfortably.
•Mind-set of continuous improvement and adapts quickly to change
•Demonstrates initiative, creativity and innovation to delivering results
•Able to solve complex problems, and resolve disagreements with informed, rational debate.
•Demonstrated ability to maintain positive attitude and apply good judgment in fast paced, dynamic environment
•Ability to work proficiently with Microsoft office applications as well as company and client systems

Physical Requirements
•Generally, performs work in busy standard office environment (or remote office) with moderate noise level, using computer and phone system (or cell phone)
•Requires ability to read and comprehend information in electronic (computer) or paper form (written/printed), or verbal.
•Requires ability to communicate and exchange information verbally and in writing
•Requires ability to use computer, phone, peripherals and office equipment
•Requires ability to consistently view a computer screen, type, and use a keyboard and mouse
•Requires ability to occasionally lift/carry/push/pull up to 10lbs.
•Requires ability to work business hours and extended hours for business needs
•Requires ability to travel at least 15% of time based upon business needs
Education and Experience: •Bachelor’s degree or equivalent combination of education and experience
•15+ years of relevant experience with proven track record of success in healthcare payer space with direct responsibility for operations with financial and strategic results metrics
• 6+ years in role with responsibility for staff management and development
•Extensive knowledge and experience with operational strategies and management in healthcare billing and recovery COB/TPL and healthcare payer environment

Performant is a government contractor. Certain client assignments for this position may require submission to and successful outcome of additional background and/or clearances throughout employment with the Company.

-Must submit to and pass background check. Must not have any Federal or State liens resulting from County, State or Federal tax issues.
-Must not have any current defaulted student loans.
-Must be able to pass a criminal background check; must not have any felony convictions or specific misdemeanors.
-Must submit to and pass drug screen.

*Job Profile is subject to change at any time and does not preclude the company or management’s right or ability to assign or reassign job duties or assignments at any time.

Performant Financial Corporation is an Equal Opportunity Employer. Performant Financial Corporation is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law.

Job Code:2019-50-6A-003