Federal IDR: Senior Operations & Strategy Lead

Florida Blue Group; United States; Híbrido; USD 109.000 - 178.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical insurance

Retirement plan

Paid time off

Wellness program

Descripción de la vacante

Florida Blue Group seeks a Senior Manager, Federal Independent Dispute Resolution (IDR) to lead a team of IDR specialists and drive enterprise outcomes under the No Surprises Act. The role blends operations with strategy, ensuring regulatory compliance, vendor performance, and tech enablement across multiple functions.

The role reports across Network, Legal, Claims, IT, and Compliance, guiding IDR exposure management and delivering better outcomes for members and self-funded groups.

Formación

• 6+ years of progressive experience in health insurance, managed care, claims, provider contracting, or related field.
• At least three years in a people leadership role.
• Bachelor’s degree required; advanced degree preferred.
• Working knowledge of the No Surprises Act and IDR process, arbitration, QPA, and regulatory timelines.
• Experience managing large budgets, forecasting, and vendor performance and contract compliance.
• Experience acting as a business or product owner for technology solutions.
• Ability to translate complex regulatory/financial information into clear recommendations.
• Strong analytical, influencing, and stakeholder management skills.

Responsabilidades

• Lead, coach, and develop a team of IDR specialists; recruit and retain talent.
• Plan, organize, and direct department activities to meet compliance metrics and KPIs.
• Act as product owner for IDR tech solutions; define requirements and roadmap.
• Oversee vendor programs, ensure contract compliance and SLAs.
• Integrate policy feedback to influence enterprise network strategy.
• Manage budgets of $30M+ with disciplined stewardship.
• Provide forecasts for IDR fees and medical expense based on trends.
• Collaborate with Network, Legal, Compliance, Account Management and Claims.
• Navigate cross-functional complexity to align priorities.
• Prepare executive reports on IDR performance and financial exposure.
• Communicate effectively with internal/external audiences, including self-funded groups.

Conocimientos

Team leadership

Operational performance

Product ownership

Vendor management

Network & policy integration

Financial management

Forecasting

Cross-functional collaboration

Complexity navigation

Executive reporting

Communication & influence

Educación

Bachelor’s degree in business, healthcare administration, finance, or related field

Descripción del empleo

Florida Blue Group seeks a Senior Manager, Federal Independent Dispute Resolution (IDR) to lead a team of IDR specialists and drive enterprise outcomes under the No Surprises Act. The role blends operations with strategy, ensuring regulatory compliance, vendor performance, and tech enablement across multiple functions.

The role reports across Network, Legal, Claims, IT, and Compliance, guiding IDR exposure management and delivering better outcomes for members and self-funded groups.