Manager, Claims Operations

HMA
vision insurance, parental leave, paid time off, paid holidays, 401(k), retirement plan, remote work
United States, Washington, Bellevue
10700 Northup Way (Show on map)
Nov 25, 2023
HMA is the premier third-party health plan administrator across the PNW and beyond. We relentlessly deliver on our promise to provide medium to large-size employers with customized health plans. We offer various high-quality, affordable healthcare plan options supported with best-in-class customer service. We are proud to say that for three years, HMA has been chosen as a 'Washington's Best Workplaces' by our Staff and PSBJ. Our vision, 'Proving What's Possible in Healthcare,' and our values, People First!, Be Extraordinary, Work Courageously, Own It, and Win Together, shape our culture, influence our decisions, and drive our results. What we are looking for: We are always searching for unique people to add to our team. We only hire people that care deeply about others, thrive in evolving environments, gain satisfaction from being part of a team, are motivated by tackling complex challenges, are courageous enough to share ideas, action-oriented, resilient, and results-driven. What you can expect: You can expect an inclusive, flexible, and fun culture, comprehensive salary, pay transparency, benefits, and time off package with plenty of personal development and growth opportunities. If you are looking for meaningful work, a clear purpose, high standards, work/life balance, and the ability to contribute to something important, find out more about us at: How YOU will make a Difference: As a Manager of Claims, you will have the opportunity to provide the leadership, management and vision necessary to ensure claims are correctly processed and paid. Claims processing and payment is the heart of our business activity. On a day-to-day basis, you will ensure we have the proper operational controls, administrative procedures, and people in place to effectively deliver timely and accurate claims payment. What YOU will do: Tracks and manages daily inventory of claims processing teams and adjusts as needed to maximize productivity and maintain service level agreements. Manages workforce planning activities, including performance management and forecasting. Creates daily updates for management team flagging production rates, critical issues and areas of escalation in real time. Leads review of claims quality measures and provides feedback for continuous improvement. Applies subject matter expertise to the business of claims processing and operations. Analyzes data, proactively assesses business needs, and adjusts resourcing levels to provide the best customer service while practicing fiscal responsibility. Manages and coaches individual contributor's performance and quality. Train and coach staff and vendors on claims processes as needed. Ability to motivate and lead team members and vendors in accordance with HMA values and objectives. Knowledge, Experience, and Key Attributes needed for Success: Bachelor's Degree or equivalent work experience. Minimum 5 years' of claims processing experience. Minimum 1 year of people leading experience. Proven ability to manage and develop a team of highly skilled staff. Proven ability to manage and interact with vendors to support execution of work within the SLA's established. Technical ability to create reports and use data to make effective decisions. Ability to develop strong partnerships and work collaboratively. Passion for excellence, flexibility, and critical thinking. Compensation: The base salary range for this position in the greater Seattle area is $86,000 - $103,000 and varies dependent on geography, skills, experience, education, and other job or market-related factors. Performance-based incentive bonus(es) is available. In addition, HMA provides a generous total rewards package for full-time employees that includes: seventeen (IC) days paid time off; eleven paid holidays, one paid personal and one paid volunteer day; company-subsidized medical, dental, vision, and prescription insurance; company-paid disability, life, and AD&D insurances; voluntary life insurances; HSA and FSA pre-tax programs; 401(k)-retirement plan with company match; wellness incentive and reimbursement; remote work and continuing education reimbursements; discount program; parental leave; and a charitable giving match. For more information about HMA, visit . Disclaimer: The salary, other compensation, and benefits information are accurate as of this posting date. HMA reserves the right to modify this information at any time, subject to applicable law. How we Support your Work, Life, and Wellness Goals We offer a comprehensive total rewards package including: competitive pay; annual incentive; wellness programs; medical, dental, and vision insurance; 401K retirement plan with match; generous PTO and holidays; an onsite gym; life, AD&D, short and long-term disability insurances; an Employee Assistance Plan with additional mental health support; free parking and easy freeway access to I-405 and I-520; a stocked kitchen on-site with subsidized snacks and refreshments; year-round wellness activities; monthly events; paid volunteer hours and more! HMA is primarily a remote workforce, requires a reliable internet connection, and provides all hardware. Some roles are required onsite 1-3 days per week/month while other roles are 100% remote. A background screen prior to employment is required. Protected Health Information (PHI) Access Healthcare Management Administrators (HMA) employees may encounter protected health information (PHI) in the regular course of their work. All PHI shall be used and disclosed on a need-to-know-basis and according to HMA's standard policies and procedures. HMA is an Equal Opportunity Employer