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Job Details

Vice President A amp H Claims Services

Location
Mountlake Terrace, WA, United States

Posted on
Aug 14,2019

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Profile

POSITION OVERVIEW:nnThis unique insurance Company is expanding the leadership team and is looking for a strong leader to provide strategy and high-level expertise.nnYou will provide operational and strategic direction to the Stop Loss, XOL and Provider Excess Claims department.nnThis role will be a key leader in the organization and will be a key contact by other departments in working through escalation of items.nnAdditionally, you will provide critical insights and direction on the High-Cost Claimant solution, creating a roadmap of future capabilities and competitive advantage insights.nnThis position will report to the VP of Service and Operations.nnESSENTIAL ELEMENTSnnYou will provide strategic direction to the claims department, using management by performance metrics.nnYou will lead by example in their process improvement and continuous learning direction.nnYou will work directly with Partner Organizations, TPAs, High-Cost Claimants (HCC) Specialty Vendors and Client clinical resources in the application of cost savings initiatives.nnDrive the expansion of relationships within the Partner Plan structure in Claims, Medical Management, and Provider Contracting.nnREQUIREMENTSnnEducation and CertificationsnnBachelors Degree requirednnMasters Degree preferrednnSix Sigma Certification preferrednnEXPERIENCEnnMinimum of 12 years claims experience with at least 5 years in Stop Loss or Large Claims area requirednnSTOP LOSS/EXCESS OF LOSS EXPERIENCE REQUIREDnn15- 20% Travel Required,

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