Supervisor Business Configuration

Independence Blue Cross; Philadelphia, Northern (Philadelphia County, KY); Híbrido; USD 90 000 - 150 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Hybrid work model

Resumo da oferta

Independence Blue Cross is seeking a senior operations leader in the Philadelphia area to supervise benefits, medical policy and product operations enablement. The role partners with internal and external teams to drive policy, process improvements, and timely responses to business partners.

The candidate will evaluate initiatives, manage resources, and oversee ticket resolution while ensuring adherence to regulatory requirements and customer satisfaction.

Qualificações

• Bachelor's degree required.
• 5+ years of supervisory experience in operations, medical policy and product management.
• Experience with Client Setup, Benefits, Medical Policy and Claims preferred.
• Strong communication skills for complex concepts with staff, management, vendors and customers.
• Advanced analytical and problem-solving abilities.
• Ability to define solutions, coordinate resources and implement changes.
• Ability to plan timelines and create dashboards for senior management visibility.

Responsabilidades

• Supervise team responsible for benefits, medical policy and product operations enablement.
• Implement departmental policies and procedures with internal and external partners.
• Evaluate projects, mandates, capacity plans and efficiency; assign resources.
• Oversee ticket inventory to ensure timely resolution across client setup teams.
• Identify trends to improve quality and inform training and DLP needs.
• Synthesize data to develop clear actions from multiple sources.
• Develop timely, complete, and accurate responses to business partners.
• Collaborate with operational leaders to identify business process improvements.
• Oversee downstream impacts including claims processing, costs to self-funded customers, coding changes, regulatory compliance, and client satisfaction.

Conhecimentos

Team supervision

Operations management

Medical policy

Product management

Client setup

Benefits

Claims knowledge

Communication skills

Analytical thinking

Problem solving

Project timelines

Dashboards

Formação académica

Bachelor's Degree

Descrição da oferta de emprego

• Responsible for supervising and overseeing team responsible for benefits, medical policy and product operations enablement. Solutions for complex benefit exceptions in FOS and HRP.
• Supervises team and implement departmental policies and procedures with all internal and external business partners.
• Evaluates projects, mandates, initiatives, capacity plans and efficiency of department and takes actions to assign resources and estimate work effort appropriately.
• Responsible for overseeing ticket inventory to ensure timely resolution across client setup teams.
• Responsible for identifying trends to improve quality and inform training and DLP needs.
• Ability to synthesize data to develop a clear course of action based on information from a variety of sources.
• Develop and ensure timely, complete, and accurate responses to business partners.
• Collaborate with Operational leaders to identify business process improvement opportunities.
• Responsible for extensive downstream impacts; including but not limited to claims processing, costs to self-funded customers, cost to modify coding, compliance with state and federal regulations, adherence to filed benefits, client and member dissatisfaction.

Qualifications

• Bachelor's Degree
• Minimum 5+ years proven supervisor and working experience in operations, medical policy and product management.
• Client Setup, Benefits, Medical Policy and Claims knowledge strongly preferred.
• Ability to manage teams with tight deliverables.
• Demonstrated effective communication skills required to address and present most complex ideas and concepts to staff, management, vendor and external customers (as needed).
• Demonstrated advanced analytical and problem-solving skills.
• Demonstrated ability to define business solutions, make decisions, identify problems, coordinate resources and implement changes.
• Ability to develop, plan, and create timelines and dashboards to support senior management visibility.

Independence has implemented a “Hybrid” model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the “Hybrid” model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania.

IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.

Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.

Inclusion and Belonging

At IBX, everyone can feel valued, supported, and comfortable to be themselves, and all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. Celebrating and embracing diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

About Our Company

Serving more than 8 million people nationwide, including 2.5 million in southeastern Pennsylvania, Independence Health Group — together with its subsidiaries — is the leading health insurance organization in the Philadelphia region. Our mission to build healthier lives for you, your family, and your employees shapes our actions and decisions every day.

At Independence, we see each of our members as an individual, with unique needs and concerns. We’re dedicated to harnessing the very latest ideas and technologies to deliver access to care that meets those needs and surpasses your expectations. For more information about Independence access our website at www.ibx.com . We’re revolutionizing health care, and our focus is on you!

IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.