Remote Claims Systems Manager - Health Insurance

Partners Health Management; Elkin (NC); Remote; USD 100,000 - 130,000; Full time

Benefits offered by this job

Annual incentive bonus plan

Medical, dental, and vision insurance

Generous vacation and sick time accrua

13 paid holidays

State Retirement (pension plan)

401(k) Plan with employer match

Company paid life and disability insur

Wellness Programs

Public Service Loan Forgiveness Qualif

Remote work option

Job summary

Partners Health Management is seeking a Claims System Manager to provide strategic leadership for the claims management system and related applications. You will oversee system configuration, development, implementation, and maintenance, working with cross-functional teams to address escalation and drive timely resolutions.

The role requires experience managing staff and vendors, defining roadmaps, and ensuring adherence to NC Medicaid rules and organizational policies.

Qualifications

• Bachelor’s degree in Business Administration, Information Systems Management, Health Information Management, or related field.
• Seven years of experience in management of data systems, with claims/health insurance focus a plus.

Responsibilities

• Oversee and provide leadership to the Claims Systems Analysts team and vendors; ensure timely hiring, supervision, evaluation, and mentoring.
• Monitor workload and staffing to maintain productivity and timely project delivery.
• Design, develop, implement, and operate the claims management software systems; provide regular status updates to VP of Business Services.
• Manage BRDs, vendor contracts, and service desk ticket resolution with cross-functional collaboration.
• Escalate items behind schedule or at risk to leadership; align with ISD architecture and policies.

Skills

Team leadership

Communication skills

Analytical/problem solving

Stakeholder management

Education

Bachelor’s degree in related field

Tools

Microsoft O365

Service desk software

Data analysis tools

Job description

Partners Health Management is seeking a Claims System Manager to provide strategic leadership for the claims management system and related applications. You will oversee system configuration, development, implementation, and maintenance, working with cross-functional teams to address escalation and drive timely resolutions.

The role requires experience managing staff and vendors, defining roadmaps, and ensuring adherence to NC Medicaid rules and organizational policies.