Remote Claims Systems Leader

Partners Behavioral Health Management; Athens (GA); Remote; USD 100,000 - 130,000; Full time

Benefits offered by this job

Annual incentive bonus

Medical/dental/vision insurance

Vacation and sick time

13 paid holidays

State retirement pension

401(k) with employer match

Life and disability insurance

Wellness programs

Public Service Loan Forgiveness

Job summary

Partners Behavioral Health Management is seeking a Claims System Manager to provide strategic leadership for the claims management system across the Information Services division. You will oversee staff and vendors, drive system enhancements, and ensure compliance with North Carolina Medicaid rules and internal policies.

The role requires strong project leadership, stakeholder collaboration, and a focus on timely, high-quality delivery of system updates and support.

Qualifications

• Bachelor’s degree in a related field and 7+ years in data systems management, preferably in claims/health insurance.
• Experience leading medium to large teams and coordinating cross-functional projects.
• Strong knowledge of Medicaid rules and regulations and project management methods.

Responsibilities

• Oversee and mentor the Claims Systems Analyst team and vendors; manage configuration, development, implementation, maintenance, and support.
• Escalate risks, track BRDs, vendor contracts, and ticket resolutions; provide status updates.
• Allocate project resources per PMO guidelines; ensure timely delivery and alignment with strategic goals.
• Develop and communicate the roadmap for the claims management system; coordinate with ISD and stakeholders.
• Ensure compliance with policies, procedures, and regulatory requirements across systems.

Skills

Leadership

Stakeholder communication

Analytical thinking

Problem solving

Project management

Education

Bachelor’s degree in Business Administration, Information Systems Management, Health Information Management

Tools

Claims management software

Data analysis tools

Microsoft O365

Service desk ticketing software

Job description

Partners Behavioral Health Management is seeking a Claims System Manager to provide strategic leadership for the claims management system across the Information Services division. You will oversee staff and vendors, drive system enhancements, and ensure compliance with North Carolina Medicaid rules and internal policies.

The role requires strong project leadership, stakeholder collaboration, and a focus on timely, high-quality delivery of system updates and support.