Position Purpose: Manage and support claims analysis and research. Provide analytical information that identifies process improvement and root cause analysis of issues. Develop and implement solutions to improve overall delivery of claims operations. Ensure claims operation is able to meet or exceed performance measures.
Education/Experience: Bachelor's degree in a related field or equivalent experience. 5+ years of experience in health plan operations, preferably with Medicare and/or Medicaid or equivalent business experience. Ability to deal with abstract variables and apply principles of logic or scientific thinking to define problems, collect data, establish facts, and draw valid conclusions. Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.