IDR Operations Lead – No Surprises Act Expert

Florida Blue; United States; Presencial; USD 109.000 - 178.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical, dental, vision insurance

Retirement Savings Plan with employer

Paid time off and holidays

Wellness program

Voluntary benefits

Descripción de la vacante

Florida Blue is seeking a Senior Manager, Federal Independent Dispute Resolution (IDR) to lead a team of IDR specialists and drive end-to-end operations in response to No Surprises Act requirements.

You will partner with IT for IDR technology, manage budgets over $30M, and influence policy and network strategy across multiple teams. The role demands strategic thinking, strong leadership, and executive communication.

Formación

• 6+ years of progressive experience in health insurance, managed care, claims, or a related field with at least 3 years in a people leadership role.
• Bachelor’s degree required; advanced degree preferred.
• Working knowledge of the federal No Surprises Act and IDR process including arbitration, QPA timelines.
• Experience managing large budgets, forecasting, and vendor performance and contract compliance.

Responsabilidades

• Lead, coach, and develop a team of IDR specialists and retain talent to achieve target results.
• Plan, organize, direct, and control department activities to meet regulatory metrics and KPIs under No Surprises Act.
• Act as product owner for IDR technology solutions by defining requirements and prioritizing the roadmap.
• Oversee vendor programs to ensure contract compliance and attainment of SLAs.
• Coordinate with Network, Legal, Compliance, and Claims to align IDR strategy with enterprise goals.
• Prepare executive-level reporting on IDR performance, trends, and financial exposure.

Conocimientos

People leadership

Budgeting & forecasting

Vendor performance management

Regulatory knowledge

Product ownership

Stakeholder management

Executive communication

Educación

Bachelor's degree in business/healthcare administration/finance

Advanced degree preferred

Descripción del empleo

Florida Blue is seeking a Senior Manager, Federal Independent Dispute Resolution (IDR) to lead a team of IDR specialists and drive end-to-end operations in response to No Surprises Act requirements.

You will partner with IT for IDR technology, manage budgets over $30M, and influence policy and network strategy across multiple teams. The role demands strategic thinking, strong leadership, and executive communication.