Cambia Health Solutions

  • Assistant Director of Claims Production

    Job Locations US-WA-Burlington | US-OR-Portland | US-ID-Lewiston
    Requisition ID
    2019-26065
    Category (Portal Searching)
    Claims/Appeals
  • Overview

    Assistant Director of Claims Production

    Burlington, WA; Portland, OR; Lewiston, ID

     

     

    At Cambia, our values are fundamental to achieving our Cause of transforming the health care industry. They guide our actions and bring diverse perspectives together to improve the health care journey better for those we serve. All eight values are equally important and linked to the others: Empathy, Hope, Courage, Trust, Commitment, Innovation, and Accountability. These values are not just words on paper - we live them every day.

     

    Achieving our ambitious Cause requires exemplary leadership. In addition to the Cambia values listed above, our leaders demonstrate the following leadership attributes: Cambia leaders think big, push boundaries, envision possibilities, inspire and empower others. They build collaborative relationships beyond their functional area and create workplaces which are just and transparent. Our leaders must be lifelong learners, develop others and act as role models for their teams, colleagues, external partners and—most importantly—our current and future members.

    Responsibilities & Requirements

    The Assistant Director provides leadership for Claims production processing activities in all LOBs claims service organization. He/she will be accountable for directing multiple operations units engaged in claims processing. Responsible for strengthening the organization’s effectiveness in claims processing by achieving satisfaction through fast and accurate claims processing.

     

    You will additionally support claims strategy by executing the tactical management of the Claims Production department, including the achievement and maintenance of all performance goals. Manages and collaborates with multiple project teams throughout all affiliate states in support of claims activities. Develops and mentors a high-performance team and fosters a collaborative relationship with internal and external customers.

     

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    Responsibilities:

     

    • Works cooperatively with executives and management teams throughout Regence to accomplish goals. Maintains a leadership team approach to resolve problems or issues of overall importance. Matters that cross functional lines directly involve the position's input and may require frequent, direct contact and close communications with all levels across Regence.
    • Drives the effectiveness of the Claims organization through appropriate organizational structure, an effective work environment, regular employee communication, recognition and development.
    • Continually strives toward increased customer satisfaction while increasing operational efficiency. This is accomplished through motivating all claims staff toward increased productivity, increased accuracy and focus on customer satisfaction.
    • Responsible for fiscal management, including budget preparation, expenditure control, and record keeping.
    • Promotes the organizational policies, procedures, and practices across division lines.
    • Strengthens the organization’s effectiveness in achieving customer satisfaction by ensuring fast and accurate claims processing.
    • Coordinates with the directors from all Regence Plans to continuously improve the cost, quality and effectiveness of Operations functions.
    • Oversees the selection, training, organization and proper compensation of Regence claims employees.
    • Accountable for ongoing staff development and succession planning.
    • Creates and manages appropriate employee incentives and recognition.
    • Partners with the Business Workforce Optimization teams to successfully implement new procedures and enhancements to claims systems that benefit our members.
    • Directs the development of Regence claims processing functions to contribute to improved productivity and accuracy in benefit application and reduced operating costs.
    • Supervises 5-10 direct reports and  300 indirects.

     

     

    Competencies and Knowledge:

     

    • Expertise regarding health plan legislation and regulations.
    • Successful experience leading health plan operations such as membership, claims customer service and analytics & reporting
    • Ability to create, execute and evaluate short- and long-term operating plans 
    • Business acumen including financial/budget management, data analysis and decision making.
    • Demonstrated ability to manage managers and lead high performing teams. Ability to effectively delegate, evaluate performance, and to motivate and develop others across multiple functions.
    • Proven competency in developing and maintaining effective relationships at all levels inside and outside of the organization.
    • Excellent verbal and written communication skills including ability to effectively convey complex or sensitive issues or regulations.

     

    Normally to be proficient in the competencies listed above:

    Assistant Director Claims Production would have a bachelor’s degree in in business management, health care administration or other related field and 5 years management/supervisory experience with at least 3 years in claims processing, customer service or membership/enrollment or an equivalent combination of education and job-related work experience.

     

     

     

    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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