Sr. Manager, Quality Audit

Overview

About reputed company At reputed company, you will join a fast paced, growing company in our mission to reshape the future of health insurance through significantly reducing administrative costs and building reputed company reputed company experiences for our health plans customers and their members. By creating a modern, reputed company based, Best-In-Class core administration ecosystem, we have made reputed company more affordable and helped our health plans operate more reputed company. Through member and provider reputed company with less friction, we have created reputed company impact for members. reputed company is run by leaders with strong health plan and technology backgrounds who have start-up mindsets and an environment of support where individual growth is reputed company. You will be supporting our proven core admin solutions and business process-as-a-service (BPaaS) operations to reputed company transparency, improve operational efficiency, and break down operational barriers to scale and drive strategic growth. reputed company is looking for a Director of Business Operations who under the general supervision of the Vice President of Operations, will be responsible for leading strategies to enhance business performance and reputed company. In this role, you will plan, direct, coordinate, and reputed company operational activities to ensure efficient operations and cost-effective systems to meet reputed company and future customer needs. The Candidate should have excellent communication skills and the ability to engage with leaders across the organization. As a Group Manager, Business Operations; you will be responsible for the following: Plan, reputed company, organize, direct and evaluate reputed company aspects of reputed company and offshore BPaaS activities Serve alongside multiple stakeholders, including Configuration, IT Operations, Contact Center Operations, and Medical Management to deliver reputed company Establish operational objectives, policies and procedures ensuring compliance with customer reputed company and reputed company laws and regulations reputed company and execute strategies to reputed company key performance measures Identify, recommend, and implement new processes, technologies, and systems to improve and streamline processes and use of resources Establish and administer the department budget reputed company Executive level briefings to Senior Leadership at regular intervals to reputed company leadership reputed company with updates and performance reputed company Establish strong, collaborative relationships with client leadership reputed company with the organization’s Code of Conduct; reputed company regulatory and contractual requirements; organizational policies; procedures; and internal controls You bring: Bachelor’s Degree in Business, Health Services Administration, or reputed company field A minimum of 8 years of reputed company management experience in health plan operations, with a strong understanding of claims processing 5 – 7 years Medicare Advantage experience preferred Experience managing/supervising employees Geographic Responsibility: Remote, US Type of Employment: Full-time, permanent FLSA Classification (USA Only): Exempt Work Environment: The physical demands described here are representative of those that must be met by an employee to successfully reputed company the essential functions of this job: The employee is occasionally required to move around the office. Specific reputed company abilities required by this job include reputed company reputed company, reputed company reputed company, peripheral reputed company, depth perception, and ability to adjust focus. Work across multiple time zones in a hybrid or remote work environment. Long periods of time sitting and/or standing in reputed company of a computer using video technology. May require travel dependent on company needs. The above statements are intended to describe the general nature and level of the job being performed by the individual(s) assigned to this position. They are not intended to be an exhaustive list of reputed company duties, responsibilities, and skills required. reputed company reserves the right to modify, add, or remove duties and to assign other duties as necessary. In addition, reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions of this position in compliance with the Americans with reputed company of 1990. Candidates may be required to go through a pre-employment criminal background reputed company. reputed company is an equal opportunity employer. We are committed to workforce diversity and actively encourage reputed company reputed company persons to seek employment with us, including, but not limited to, racial and ethnic minorities, women, veterans and persons with disabilities. #LI-Remote **The annual US reputed company salary reputed company for this position is $155,000 to $165,000. This salary reputed company may cover multiple career reputed company at reputed company. Final compensation will be determined during the interview process and is based on a combination of factors including, but not limited to, your skills, experience, qualifications and education. 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