Dir Claims Operations

Our mission is to SAVE AND IMPROVE LIVES BY EMPOWERING HEALTHCARE CONSUMERS. Come be part of remarkable.

How you can make a difference  

We are looking for experienced leader with passion for driving process improvements and strengthening relationships within the team and company. With high level direction set by business unit and organizational senior leadership, this position is responsible for the overall strategic direction and daily operational functions for Claims Operations.  This includes planning, developing and directing all aspects of the organization’s claim programs as well as the establishment, implementation and maintenance of service standards.  Ensures that claim handling expectations and service levels are met for multiple, geographically diverse centers.

What you’ll be doing 

• Remarkable ‘purple’ service to internal and external customers, embracing the feedback provided as a basis for evaluating quality and determining opportunities for investment to maintain and enhance customer loyalty.
• Continuous, sustainable efficiency improvement through investments in customer self-service, automation, process engineering, strategic in/outsourcing and other strategies.
• Provides direction to Claim Operations management team, establishing major functional roles, courses of action and tactical programs that are aligned with strategic long-term division objectives and directly related to the core values of the business.   Provides leadership in the definition and establishment of standards, internal control mechanisms, key performance measures and standard operating procedures across multiple platforms.  Represents and communicates this approach to management and staff.
• Directs and oversees the initial and ongoing evaluation of customer needs and establishment of processes and procedures related to daily Claims Service Administration.  Ensures overall customer satisfaction by supporting and/or promoting continuous improvement of account management, administrative processes, client set-up, ongoing administration, and claims services.  This includes providing support to the sales team in client presentations, site visits, proposals and projects.
• Sets tactical and long-term goals for each team, aligning objectives with targets established by the division’s executive leadership team.  Develops metrics related to key business drivers to measure performance and then monitors, assesses and evaluates performance.  Takes action to change the course of direction, including recommending and/or approving changes in plans.  Reports progress and performance to leadership as appropriate and provides feedback to team members on results.
• Regularly reviews the progress and quality level of service operations.  Ensures that questions are addressed, decisions have been acted upon and problems have been resolved.  Directs meetings where necessary to address escalated issues and resolve problems.
• Handles and oversees administrative matters concerning the service organization, including preparing and submitting assigned claims budgets for approval.  This position is also responsible for monitoring and controlling budget performance and taking action to implement cost saving strategies where available.
• Determines areas of cost reduction and program improvement where appropriate and modifies strategies, organization of resources and business plans where necessary.  This position has full cost center accountability and specific responsibility for margin targets as assigned.

• Initiates and approves human resource planning, selection and resource allocation activities that support the Claims teams’ productivity and effectiveness.  This includes ongoing responsibility for personnel actions, including hiring and scheduling employees; training and evaluating employees; coaching, counseling and managing performance; and making salary, merit or other pay increase recommendations.  Makes recommendations and/or takes corrective action to manage performance as appropriate.
• Maintains a level of currency in claims operations as well as the HR services industry by participating with and maintaining memberships with professional work groups; attending trainings, seminars, and other business-related conferences; and interfacing with peers.

What you will need to be successful

• The ability to effectively plan, develop, and direct all aspects of a claims and transaction processing business as normally obtained through at least 10 years’ experience in a high-volume claims processing environment at a manager level or greater.
• A proven track record for service excellence, process improvements, integrity and ethics.
• Excellent negotiation, leadership, communication, presentation and interpersonal skills are required to perform the functions as described.  Incumbents must have the ability to navigate political arenas with ease as well as persuade and negotiate with others while projecting a professional image.
• A demonstrated ability to resolve complex process/systems issues through the identification and analysis of problems from root cause to strategy development and execution is necessary.  Incumbents must have the ability to implement and manage comprehensive policies, programs and initiatives as described.
• A strong attention to detail and the ability to remain highly organized, professional and focused is essential.  Excellent planning, time management, decision-making and organizational skills are required.  Incumbents must be able to employ good analytical skills to develop and implement actionable work plans to meet organizational needs.
•  Experience in the HR service, financial services or similar industries is preferred.

#LI-Remote

This is a remote position.

The compensation range describes the typical minimum or maximum base pay range for this position. The actual compensation offer is determined based on job-related knowledge, education, skills, experience, and work location. This position will be eligible for performance-based incentives and restricted stock units as part of the total compensation package, in addition to a full range in addition to a full range of benefits including:

• Medical, dental, and vision
• HSA contribution and match
• Dependent care FSA match
• Uncapped paid time off
• Adventure accounts
• Paid parental leave
• 401(k) match
• Personal and healthcare financial literacy programs
• Ongoing education & tuition assistance
• Gym and fitness reimbursement
• Wellness program incentives

Why work with HealthEquity 

HealthEquity has a vision that by 2030 we will make HSAs as wide-spread and popular as retirement accounts. We are passionate about providing a solution that allows American families to connect health and wealth. Join us and discover a work experience where the person is valued more than the position. Click here to learn more. 

You belong at HealthEquity!

HealthEquity, Inc. is an equal opportunity employer, and we are committed to being an employer where no matter your background or identity – you feel welcome and included. We ensure equal opportunity for all applicants and employees without regard to race, age, color, religion, sex, sexual orientation, gender identity, national origin, status as a qualified individual with a disability, veteran status, or other legally protected characteristics. HealthEquity is a drug-free workplace. For more information about our EEO policy, or about HealthEquity’s applicant disability accommodation, drug-free-workplace, background check, and E-Verify policies, please visit our Careers page.

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