Cambia Health Solutions

  • Manager ASO Operation Services

    Job Locations US-WA-Burlington
    Requisition ID
    2018-25193
    Category (Portal Searching)
    Management
  • Overview

    As the Manager of ASO Operation Services, you will provide technical guidance, assistance and coordination of all ASO Operational activities. You will also insure cost effective accomplishment of thedivision, the overall ASO Unit,  Cambia corporate goals and the effective operation of daily activities. The ASO Operations Manager may have responsibility for ASO Appeals, Complaints, Correspondence, Customer Service, Claims, Membership and Billing.

    Responsibilities & Requirements

    TECHNICAL WORK:

    • Strong understanding of the applicable laws and rules for the division.
    • Contract expert, knowledge and ability to execute all ASO contract obligations pertaining to their division.
    • Works with other ASO divisions to ensure ASO contract obligations are met.
    • Identifies and coordinates delivery of learning interventions directly linked to specific business initiatives and requirements.
    • Recommends, develops, promotes and coordinates training, continuing education and development efforts including departmental training to support short- and long-range corporate goals and objectives.

     

    MANAGEMENT WORK:

    • Forecast, budget and determine staff needs for the division.
    • Ensure all performance guarantees and MTM metrics related to the division are met.
    • Ensure all contract obligations are met.
    • Documents the work of the division and ensures processes are in place for all of the divisions work.
    • Ensure the implementation of new groups.
    • Participate in responding to RFP requests.
    • Manages Performance and Training Teams that support the Divisions work.
    • Maintains good working relationship and cooperate with all departments in the company.
    • Participate in company wide improvement and efficiency teams where appropriate. Leads, plans, develop and directs division activities.
    • Manages all activities related to the various electronic systems used to support the division.
    • Responsible for the activities performed by division staff to assure performance goals are met including productivity, accuracy, timeliness and quality of service to our groups, members and business partners.
    • Manages the development and maintenance of identified documentation which exists to support accurate, efficient operations.
    • Provides on-going leadership to employees by facilitating and making timely decisions, providing effective communication and motivation.
    • Ensures that performance is maintained within the approved budget and continually strives to support division or line of business profitability.
    • Actively participates in corporate planning teams, when division will be impacted.
    • Manages the day-to-day activities of the direct staff to achieve goals within budgeted funds and available resources. Plans and organizes workloads and staff assignments, reviews progress, and directs changes in priorities and schedules as needed to assure corporate goals are met.
    • Selects, manages, and evaluates staff. Prepares and conducts performance evaluations and initiates disciplinary actions as warranted. Provides training and motivation to make full use of individual capabilities.
    • Assesses divisions development needs and recommends strategies and tactics to meet goals. Serves as a member to management and supervisory committees as needed. Forecasts future training and development needs to ensure necessary employee skills for effective performance.

     

    MINIMUM JOB QUALIFICATIONS AND COMPETENCIES:

     

    • An undergraduate degree with a major in business or healthcare or at least 5 years of progressive management and supervising experience related to health plan and benefit administration.
    • Experienced in managing people, projects and processes within a service environment.
    • Solid understanding and knowledge of all systems and processes used within the division, including system and staff capabilities.
    • Ability to communicate about the division’s purpose, priorities and work to both internal and external stakeholders.
    • Demonstrated ability to plan and organize with emphasis on systems and management controls.
    • Good understanding of member service functions, including experience in managing high volume production environments.
    • Demonstrated project management skills.
    • Demonstrated ability in financial and budget management.
    • Ability to make decisions, accept responsibility and be held accountable.
    • Ability to communicate effectively, verbally and in writing, to all levels of the work force, clients and agents with exceptional results.
    • Demonstrated success in cost reduction and control.

    About Us

    Regence employees are part of the larger Cambia family of companies, which seeks to drive innovative health solutions. We offer a competitive salary and a generous benefits package. We are an equal opportunity employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A drug screen and background check is required.

     

    Regence is 2.2 million members, here for our families, co-workers and neighbors, helping each other be and stay healthy and provide support in time of need. We've been here for members more than 100 years. Regence is a nonprofit health care company offering individual and group medical, dental, vision and life insurance, Medicare and other government programs as well as pharmacy benefit management. We are the largest health insurer in the Northwest/Intermountain Region, serving members as Regence BlueShield of Idaho, Regence BlueCross BlueShield of Oregon, Regence BlueCross BlueShield of Utah and Regence BlueShield (in Washington). Each plan is an independent licensee of the Blue Cross and Blue Shield Association.

    If you’re seeking a career that affects change in the health care system, consider joining our team at Cambia Health Solutions. We advocate for transforming the health care system by making health care more affordable and accessible, increasing consumers’ engagement in their health care decisions, and offering a diverse range of products and services that promote the health and well-being of our members. Cambia's portfolio of companies spans health care information technology and software development; retail health care; health insurance plans that carry the Blue Cross and Blue Shield brands; pharmacy benefit management; life, disability, dental, vision and other lines of protection; alternative solutions to health care access and free-standing health and wellness solutions.

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