Senior Manager of Insurance Operations Systems
New
We operate on PST and candidates in any time zone are welcome to apply., PSTFull-TimeManager
Salary$120,000 - $150,000
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Job Details
- Experience
- 6+ years
- Required Skills
- Project ManagementData AnalysisLooker
Requirements
- 6+ years of experience in healthcare operations and systems
- Senior Manager-level experience with a track record of leading and developing systems setup and optimization
- Strong skills in managing relationships with product teams, including external third party product teams
- Strong operational mindset with experience building or improving processes and systems
- Proven ability to work cross-functionally and influence stakeholders
- Analytical thinker with experience using data and reporting to inform decisions
- Experience with NCQA standards
- Experience using data reporting tools like Verifiable, Looker, or Mode
- Experience in large scale product migration preferred
Responsibilities
- Oversee and enhance the credentialing and enrollment software system to meet NCQA standards, reporting requirements and cross-functional needs
- Develop a deep understanding of system capabilities to improve efficiency, visibility, and operational effectiveness
- Lead and drive initiatives aimed at improving end-to-end provider experience
- Take a proactive, project-based approach to identifying organizational needs and building scalable workflows
- Deeply understand the vendor and collaborative space regarding our current and potential future vendor solutions
- Leverage AI via internal and vendor solutions to improve quality and efficiency of the processes
- Develop reporting and insights by leveraging data from multiple systems (e.g., Verifiable, Internal tools, Looker, and Mode)
- Analyze the process and operational data to identify trends, surface opportunities, and inform decision-making
- Lead new vendor requests through the legal and security review process
- Ensure that vendor teams are appropriately resourced and meeting the agreed terms
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