Assistant Director Claims Production

Join to apply for the Assistant Director Claims Production role at Regence Blue Cross Blue Shield of Utah

Oregon, Washington, Idaho or Utah - Hybrid (in office 3 days a week)

Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system.

Every day, Cambia’s dedicated team is living our mission to make health care easier and lives better. As a member of the Payment Integrity team, our Assistant Director Claims Production provides leadership for Claims production processing activities in the commercial claims service organization and is responsible for strengthening the organization’s effectiveness in claims processing by achieving satisfaction through fast and accurate claims processing – all in service of creating a person-focused health care experience.

As a people leader, you are willing to learn and grow, understanding that leadership is a craft that is continuously honed as you support your team and the lives that depend upon us.

Are you a proven health plan operations leader? Do you pride yourself in developing and mentoring high performance teams? Then this role may be the perfect fit.

• Bachelor’s degree in business management, health care administration or another related field.
• 5 years management/supervisory experience with at least 3 years in claims processing, customer service or membership/enrollment or an equivalent combination of education and job-related work experience.

• Expertise regarding health plan legislation and regulations.
• Successful experience leading health plan operations such as membership, claims customer service and analytics & reporting.
• Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired.
• Ability to create, execute and evaluate short- and long-term operating plans.
• Business acumen including financial/budget management, data analysis and decision making.
• Demonstrated ability to manage managers and lead high performing teams. Ability to effectively delegate, evaluate performance, and to motivate and develop others across multiple functions.
• Proven competency in developing and maintaining effective relationships at all levels inside and outside of the organization.
• Excellent verbal and written communication skills including ability to effectively convey complex or sensitive issues or regulations.

• Works cooperatively with executives and management teams throughout Cambia to accomplish goals. Maintains a leadership team approach to resolve problems or issues of overall importance. Matters that cross functional lines directly involve the position's input and may require frequent, direct contact and close communications with all levels across Cambia.
• Drives the effectiveness of the Claims organization through appropriate organizational structure, an effective work environment, regular employee communication, recognition and development.
• Continually strives toward increased customer satisfaction while increasing operational efficiency. This is accomplished through motivating all claims staff toward increased productivity, increased accuracy and focus on customer satisfaction.
• Responsible for fiscal management, including budget preparation, expenditure control, and record keeping.
• Strengthens the organization’s effectiveness in achieving customer satisfaction by ensuring fast and accurate claims processing.
• Coordinates with the directors from all Regence Plans to continuously improve the cost, quality and effectiveness of Operations functions.
• Oversees the selection, training, organization and proper compensation of Cambia claims employees.
• Creates and manages appropriate employee incentives and recognition.
• Partners with the Business Workforce Optimization teams to successfully implement new procedures and enhancements to claims systems that benefit our members.
• Directs the development of Cambia claims processing functions to contribute to improved productivity and accuracy in benefit application and reduced operating costs.
• As a member of our strong…