Claims Director

* Claims Director
*
* About the Role:

* * We're looking for a Claims Director
* to lead claims operations for Contra Costa Health Plan (CCHP), a large public health plan serving over 250,000 residents. This is a
* contract-to-hire leadership role
* overseeing a team of about 20 (including managers, supervisors, and claims staff). You'll drive strategy, optimize workflows, and ensure accurate, timely claims processing across Medi-Cal, Medicare, and commercial lines of business.

* Key Responsibilities:

* * Lead and manage all claims operations, including adjudication, adjustments, and payment integrity.

* Oversee and coach managers and supervisors; ensure team performance and development.

* Optimize workflows and implement process improvements for efficiency.

* Manage vendor relationships and Epic Tapestry system enhancements (training provided).

* Ensure compliance with Medi-Cal, Medicare, and regulatory requirements.

* Monitor KPIs for timeliness, accuracy, and compliance.

* Collaborate with Provider Relations, Finance, Compliance, IT, and other departments.

* Address provider disputes and billing questions; support positive provider relationships.

* Lead initiatives for backlog reduction, performance improvement, and system optimization.

* Top Priorities When You Start:
* * Reduce a large backlog of pending claims.

* Implement performance improvement initiatives.

* Optimize department workflows for greater efficiency.

* What We're Looking For:

*
* * Managed Care Leadership:
* Experience leading claims operations in a health plan environment.

* * Regulatory Knowledge:
* Strong understanding of Medi-Cal and Medicare requirements.

* * Strategic & Analytical:
* Ability to translate regulations into operational strategies.

* * Communication

Skills:

* Comfortable presenting complex issues to leadership and external partners.

* * Technology Savvy:
* Familiarity with claims systems (Epic Tapestry experience is a plus).

* Why This Role Matters:
* You'll shape the strategic direction of claims operations, ensure compliance, and support provider relationships-all while impacting healthcare access for Contra Costa County's most vulnerable populations.

* Schedule:

* Full-time, onsite/hybrid leadership role

* Education:

* Bachelor's degree in business, finance, or related field

* Experience:

* 5+ years in healthcare management, with at least 3 years in claims or patient financial services

* Job Type & Location
* This is a Contract to Hire position based out of Concord, CA.

* Pay and Benefits
* The pay range for this position is $75.00 - $80.00/hr.
Eligibility requirements apply to some benefits and may depend on your job
classification and length of employment. Benefits are subject to change and may be
subject to specific elections, plan, or program terms. If eligible, the benefits
available for this temporary role may include the following:

* Medical, dental & vision

* Critical Illness, Accident, and Hospital

* 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available

* Life Insurance (Voluntary Life & AD&D for the employee and dependents)

* Short and long-term disability

* Health Spending Account (HSA)

* Transportation benefits

* Employee Assistance Program

* Time Off/Leave (PTO, Vacation or Sick Leave)

* Workplace Type
* This is a hybrid position in Concord,CA.

* Final date to receive applications
* This position is anticipated to close on Jan 22, 2026.
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About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change.

That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

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