Remote Claims Systems Leader

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

Benefits offered by this job

Annual incentive bonus

Health insurance

Pension plan

401(k) employer match

Life and disability insurance

Wellness programs

Public Service Loan Forgiveness (PSLF)

Job summary

Partners Behavioral Health Management seeks a Claims System Manager to lead a team of analysts and vendors, shaping the roadmap for the claims management system within the Information Services division. You will collaborate with cross-functional teams to implement strategic initiatives and ensure compliant operations aligned with North Carolina Medicaid regulations.

The role emphasizes oversight of BRDs, contracts, and service desk resolutions, with regular progress updates to leadership.

Qualifications

• Bachelor's degree required or equivalent
• Minimum seven years of management experience in data systems or health insurance environments
• Five+ years in a supervisory/managerial role
• Experience with claims management systems and cross-functional collaboration

Responsibilities

• Oversee staff and vendors responsible for system configuration, development, and support
• Manage BRDs, vendor contracts, and ticket resolution with regular status updates
• Escalate issues behind schedule or at risk to organization and ensure timely resolution
• Ensure alignment of software usage with policies and NC Medicaid rules
• Provide strategic roadmap for claims management system and coordinate with ISD and PMO teams
• Track and communicate project health and status to leadership
• Coordinate across ISD teams to prioritize projects, reports, and enhancements

Skills

Team leadership

Project management

Stakeholder communication

Vendor management

Claims systems knowledge

Strategic roadmapping

Analytical/problem solving

MS Office/Office 365

Report writing

Education

Bachelor’s degree in Business Administration, Information Systems Management, Health Information Management, or closely related field

Tools

Service desk software

Pivot tables

Data analysis tools

Claims management software

Job description

Partners Behavioral Health Management seeks a Claims System Manager to lead a team of analysts and vendors, shaping the roadmap for the claims management system within the Information Services division. You will collaborate with cross-functional teams to implement strategic initiatives and ensure compliant operations aligned with North Carolina Medicaid regulations.

The role emphasizes oversight of BRDs, contracts, and service desk resolutions, with regular progress updates to leadership.