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Senior Director, Claims Operations

Company: Centene Coproration
Location: Saint Louis
Posted on: July 15, 2019

Job Description:

Description: Position Purpose: Direct the day-to-day operations of the Claims Department to ensure accurate and timely processing of members medical claims within established state and company compliance guidelines Position Responsibilities: Partner with multiple stakeholders business unit and health plan leadership to establish operational objectives and procedures Oversee implementation of operational efficiencies and development of best practice policies and procedures Monitor and analyze costs, prepare annual budget and operate department with the budget Establish consolidated and consistent processes and relationships with internal and external partners to support the business in achieving its strategic and tactical objectives Achieve and maintain all processing and expense standards relating to the Claim Operations Collaborate with various cross-functional leaders to identify and execute process improvements and effective initiatives Oversee all compliance standards for claims, ensuring operations are actively managing and reducing operational risk Oversee change management, and communication and dissemination of critical information to stakeholders, partners, leaders and peers both upstream and downstream Assess progress and report statuses to upper management and key stakeholders including timelines and milestones Analyze customer impact and respond to complex escalated customer service issues to ensure the customer expectations are consistently exceeded

Keywords: Centene Coproration, St. Louis , Senior Director, Claims Operations, Executive , Saint Louis, Missouri

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