VP, Operations (Remote)
Glastonbury, CT jobs
Travel Insured International (TII), a Crum & Forster company, is hiring for a VP, Operations, TII.
Travel Insured International is a leading travel insurance provider with more than 30 years in business. As a key component of our Specialty Business Unit, within the Accident & Health division, TII provides travel protection plans to help each individual travel confidently. Travel Insured International is proud to offer products to consumers and to agency partners of all sizes. We're committed to providing dependable coverage, great value, and customer satisfaction.
Job Description
TII is dramatically transforming its customer and partner support services to simplify a customer's journey through their travel insurance plan experience. Our goal is to personalize each interaction through a set of omni-channel capabilities where customer questions are answered the first time, and their experience is backed up by a best-in-class experience rating.
As the Vice President, Operations, TII, you will play a pivotal role in shaping and executing TII's operational strategy to achieve key performance and scalability goals. You will have the opportunity to lead by example, foster a culture of empathy and support, and drive operational excellence across our contact center, claims administration and quality assurance departments. This is an exciting opportunity for an accomplished operations leader to make a significant impact in transforming travel insurance experiences.
Reporting to the President, TII, this is a crucial role in our organization for both day-to-day operational success as well as long-term operational strategy, planning, and optimization. This leader will be responsible not only for the performance of more than a hundred individuals on the team but also for the cross-functional partnership between operations and other departments at the company, including Sales, Account Management, Marketing, Product Management, Underwriting, Strategy, PMO, Continuous Improvement, IT, Compliance and HR/Training.
The VP, Operations, will also build and leverage relationships with clients to achieve the goals of the company. The work will be fast paced with evolving needs, requiring flexibility, emotional intelligence, curiosity, and grace under pressure. As you onboard and assimilate to the role, TII, A&H and C&F, you can expect to roll up your sleeves to immerse yourself in the day-to-day work of the team to understand and impact continual improvement efforts.
This role sits on our Senior Executive Leadership team and is a Leader of Leaders, with 4 direct reports.
What you will do:
Oversee and lead Call Center, Claims, Quality Assurance and 3rd Party Vendor operational departments and functions which includes: omni-channel inbound customer service and sales, claims intake and customer service, claims adjudication, quality assurance programs for customer service and claims activities, appeal and complaint resolution, subrogation recovery activities, and third-party vendor management oversight.
Direct and lead an engaged workforce including customer experience, workforce planning, training and performance management. Provide coaching and mentorship to staff to foster talent and grow the organization.
Develop and oversee staffing plans to organizational budget for all functions and departments.
Collaborate cross functionally with Sales, Account Management, Marketing, Product Management, Underwriting, Strategy, PMO, Continuous Improvement, IT, Compliance, HR/Training, and other teams to achieve goals and partner on their planned initiatives.
Maintain operational excellence by implementing efficient processes, optimizing workflows, and leveraging technology to drive productivity and cost-effectiveness.
Skillfully develop and manage relationships with external clients and partners, in collaboration with Business Development and Account Management teams.
Carefully manage operational expense with an eye towards financial responsibility and company growth trajectory.
Provide management and oversight of third-party vendor relationships and services, including ongoing performance management, audits, contract renewals, RFPs and business reviews.
Call Center: Customer Service, Inbound Sales, Partner Support Service, Claims Customer Service
Leads the development and execution of the service model including strategy, performance and employee engagement.
Develop and then execute a robust 3-5-year strategic roadmap to deliver market required capabilities, emerging contact center technologies, industry best practices and innovation to support customer growth and retention outcomes.
Execute roadmap to deliver enhanced self-service capabilities, increased revenue generating capacity (inbound service to sales optimization), and third-party augmentation.
Develop and implement new processes to incorporate digitally enabled services that encompass consumer value chain, from plan purchase to plan engagement to claims transactions.
Drive excellence in key service performance metrics, including ASA, abandonment rates, quality service scores, first call resolution, sales conversion and call center satisfaction.
Collaborate and coordinate efforts with IT to continuously assess and optimize the contact center infrastructure, including maintaining direct production support and configuration responsibilities for the IVR and ancillary enterprise telephony environment.
Oversee business readiness of new programs and technology in partnership with IT, Sales & Account Management, Marketing, Product and Operations.
Claims Administration: First Notice of Loss (FNOL), Claims Intake Support, Adjudication
Create, communicate, and drive an aligned Claims strategy with emphasis on quality adjusting practices, process automation, and customer experience delivery.
Ensure effective management of all claims, processing service levels, and claims issues, provide quality management and technical oversight to ensure execution of the company's claims policies and philosophies.
Drive and facilitate planning and evaluation activities including budgets, forecasts, loss costs calculations, data analytics, setting and adjusting reserves, and effective risk transfer, as applicable
Exhibit keen understanding of travel insurance industry practices and trends, and of the competitive landscape.
Quality Assurance: Auditing, Resolutions, Subrogation
Lead a team of Quality Assurance, Appeal and Complaint Resolution, and Subrogation professionals who manage and implement effective Quality Assurance programs for TII's customer service and claims operations.
Develop and execute the TII Quality Assurance strategy aimed at driving continuous process and talent improvement while delivering a return on QA resource investment.
Provide guidance to audit quality control framework and maintain compliance with audit methodology, while also operating within industry best practices, applicable regulations, and internal and external professional practice expectations.
Support strategic initiatives of the business as well as the larger corporate quality assurance, internal and external audit and compliance obligations.
Support the preparation of responses to regulatory and compliance inquiries, complaints, and examinations.
Other duties as required.
What YOU will bring to C&F:
Transformational Experience: Extensive experience in leading and executing transformational initiatives, driving change, and implementing innovative solutions to enhance organizational effectiveness and competitiveness.
Proven Leadership Success: Demonstrated success in guiding and developing experienced leaders and their teams to maintain high levels of employee engagement.
Large Team Management: Proven ability to successfully manage and lead large teams, ensuring alignment with organizational goals and fostering a high-performance culture.
Outstanding Communicator: Highly effective written and verbal communication skills, including proficiency in developing and delivering presentations. Ability to tailor communication styles to different audiences, including internal cross-functional teams and external customers and partners.
Strategic mindset: Proven abilities to develop and execute operational strategies aligned with the organization's goals and objectives. Aptitude for identifying trends, patterns, and operational bottlenecks to proactively address challenges and optimize processes.
Analytical mindset: Thinks analytically with the ability to articulate complex ideas into clear frameworks; uses data to conduct root cause analysis and develops high quality, consumable, and consistent metrics that drive strategic objectives and priorities.
Customer Centric: skilled at prioritizing the customers' needs and experiences, understanding what they want and delivering exceptional service.
Has a thorough understanding of our industry, the relevant business landscape, and trends in growth and insurance environments; can spot early indicators of change and apply strategies to adapt quickly is required.
Flexible and agile, comfortable with the ambiguity of a growing and transforming organization, skilled at working and building culture in remote environments.
Requirements:
A bachelor's degree is required
15+ years of progressive experience in Operations Management roles including the areas of: Contact Center; Claims; Quality Assurance and Vendor Management are required.
10+ years of experience in people management, which includes leadership of leaders.
Experience with financial management principles, including budgeting, cost control, and revenue generation. Experience in managing operational expenses while ensuring financial responsibility and achieving profitability targets is required.
In-depth knowledge and experience in call center operations, including call management, queue management, and call routing strategies is required.
Understanding of contact center metrics, such as Average Handle Time (AHT), First Call Resolution (FCR), Service Level Agreement (SLA), and Customer Satisfaction (CSAT) is required.
Familiarity with call center technologies, including Automatic Call Distribution (ACD) systems, Interactive Voice Response (IVR) systems, and Computer Telephony Integration (CTI) is required.
Proficiency in workforce management principles and tools to optimize staffing levels, scheduling, and forecasting is required.
Proficiency in data analysis and interpretation to drive data-driven decision-making and operational improvements is required.
#LI-MS
#LI-REMOTE
What C&F will bring to you
Competitive compensation package
Generous 401K employer match
Employee Stock Purchase plan with employer matching
Generous Paid Time Off
Excellent benefits that go beyond health, dental & vision. Our programs are focused on your whole family's wellness, including your physical, mental and financial wellbeing
A core C&F tenet is owning your career development, so we provide a wealth of ways for you to keep learning, including tuition reimbursement, industry-related certifications and professional training to keep you progressing on your chosen path
A dynamic, ambitious, fun and exciting work environment
We believe you do well by doing good and want to encourage a spirit of social and community responsibility, matching donation program, volunteer opportunities, and an employee-driven corporate giving program that lets you participate and support your community
At C&F you will BELONG
If you require special accommodations, please let us know. We value inclusivity and diversity. We are committed to equal employment opportunity and welcome everyone regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status. If you require special accommodations, please let us know. Belonging at C&F, is a mindset. It's about fostering a culture of inclusion and connection, where everyone feels valued, heard, and empowered to thrive and where our social impact efforts help strengthen the communities where we live and work.
For California Residents Only: Information collected and processed as part of your career profile and any job applications you choose to submit are subject to our privacy notices and policies, visit **************************************************************** for more information.
Crum & Forster is committed to ensuring a workplace free from discriminatory pay disparities and complying with applicable pay equity laws. Salary ranges are available for all positions at this location, taking into account roles with a comparable level of responsibility and impact in the relevant labor market and these salary ranges are regularly reviewed and adjusted in accordance with prevailing market conditions. The annualized base pay for the advertised position, located in the specified area, ranges from a minimum of $200,000 to a maximum of $250,000. The actual compensation is determined by various factors, including but not limited to the market pay for the jobs at each level, the responsibilities and skills required for each job, and the employee's contribution (performance) in that role. To be considered within market range, a salary is at or above the minimum of the range. You may also have the opportunity to participate in discretionary equity (stock) based compensation and/or performance-based variable pay programs.
Auto-ApplyVP, Operations (Remote)
Glastonbury, CT jobs
Travel Insured International (TII), a Crum & Forster company, is hiring for a VP, Operations, TII. Travel Insured International is a leading travel insurance provider with more than 30 years in business. As a key component of our Specialty Business Unit, within the Accident & Health division, TII provides travel protection plans to help each individual travel confidently. Travel Insured International is proud to offer products to consumers and to agency partners of all sizes. We're committed to providing dependable coverage, great value, and customer satisfaction.
Job Description
TII is dramatically transforming its customer and partner support services to simplify a customer's journey through their travel insurance plan experience. Our goal is to personalize each interaction through a set of omni-channel capabilities where customer questions are answered the first time, and their experience is backed up by a best-in-class experience rating.
As the Vice President, Operations, TII, you will play a pivotal role in shaping and executing TII's operational strategy to achieve key performance and scalability goals. You will have the opportunity to lead by example, foster a culture of empathy and support, and drive operational excellence across our contact center, claims administration and quality assurance departments. This is an exciting opportunity for an accomplished operations leader to make a significant impact in transforming travel insurance experiences.
Reporting to the President, TII, this is a crucial role in our organization for both day-to-day operational success as well as long-term operational strategy, planning, and optimization. This leader will be responsible not only for the performance of more than a hundred individuals on the team but also for the cross-functional partnership between operations and other departments at the company, including Sales, Account Management, Marketing, Product Management, Underwriting, Strategy, PMO, Continuous Improvement, IT, Compliance and HR/Training.
The VP, Operations, will also build and leverage relationships with clients to achieve the goals of the company. The work will be fast paced with evolving needs, requiring flexibility, emotional intelligence, curiosity, and grace under pressure. As you onboard and assimilate to the role, TII, A&H and C&F, you can expect to roll up your sleeves to immerse yourself in the day-to-day work of the team to understand and impact continual improvement efforts.
This role sits on our Senior Executive Leadership team and is a Leader of Leaders, with 4 direct reports.
What you will do:
* Oversee and lead Call Center, Claims, Quality Assurance and 3rd Party Vendor operational departments and functions which includes: omni-channel inbound customer service and sales, claims intake and customer service, claims adjudication, quality assurance programs for customer service and claims activities, appeal and complaint resolution, subrogation recovery activities, and third-party vendor management oversight.
* Direct and lead an engaged workforce including customer experience, workforce planning, training and performance management. Provide coaching and mentorship to staff to foster talent and grow the organization.
* Develop and oversee staffing plans to organizational budget for all functions and departments.
* Collaborate cross functionally with Sales, Account Management, Marketing, Product Management, Underwriting, Strategy, PMO, Continuous Improvement, IT, Compliance, HR/Training, and other teams to achieve goals and partner on their planned initiatives.
* Maintain operational excellence by implementing efficient processes, optimizing workflows, and leveraging technology to drive productivity and cost-effectiveness.
* Skillfully develop and manage relationships with external clients and partners, in collaboration with Business Development and Account Management teams.
* Carefully manage operational expense with an eye towards financial responsibility and company growth trajectory.
* Provide management and oversight of third-party vendor relationships and services, including ongoing performance management, audits, contract renewals, RFPs and business reviews.
Call Center: Customer Service, Inbound Sales, Partner Support Service, Claims Customer Service
* Leads the development and execution of the service model including strategy, performance and employee engagement.
* Develop and then execute a robust 3-5-year strategic roadmap to deliver market required capabilities, emerging contact center technologies, industry best practices and innovation to support customer growth and retention outcomes.
* Execute roadmap to deliver enhanced self-service capabilities, increased revenue generating capacity (inbound service to sales optimization), and third-party augmentation.
* Develop and implement new processes to incorporate digitally enabled services that encompass consumer value chain, from plan purchase to plan engagement to claims transactions.
* Drive excellence in key service performance metrics, including ASA, abandonment rates, quality service scores, first call resolution, sales conversion and call center satisfaction.
* Collaborate and coordinate efforts with IT to continuously assess and optimize the contact center infrastructure, including maintaining direct production support and configuration responsibilities for the IVR and ancillary enterprise telephony environment.
* Oversee business readiness of new programs and technology in partnership with IT, Sales & Account Management, Marketing, Product and Operations.
Claims Administration: First Notice of Loss (FNOL), Claims Intake Support, Adjudication
* Create, communicate, and drive an aligned Claims strategy with emphasis on quality adjusting practices, process automation, and customer experience delivery.
* Ensure effective management of all claims, processing service levels, and claims issues, provide quality management and technical oversight to ensure execution of the company's claims policies and philosophies.
* Drive and facilitate planning and evaluation activities including budgets, forecasts, loss costs calculations, data analytics, setting and adjusting reserves, and effective risk transfer, as applicable
* Exhibit keen understanding of travel insurance industry practices and trends, and of the competitive landscape.
Quality Assurance: Auditing, Resolutions, Subrogation
* Lead a team of Quality Assurance, Appeal and Complaint Resolution, and Subrogation professionals who manage and implement effective Quality Assurance programs for TII's customer service and claims operations.
* Develop and execute the TII Quality Assurance strategy aimed at driving continuous process and talent improvement while delivering a return on QA resource investment.
* Provide guidance to audit quality control framework and maintain compliance with audit methodology, while also operating within industry best practices, applicable regulations, and internal and external professional practice expectations.
* Support strategic initiatives of the business as well as the larger corporate quality assurance, internal and external audit and compliance obligations.
* Support the preparation of responses to regulatory and compliance inquiries, complaints, and examinations.
* Other duties as required.
What YOU will bring to C&F:
* Transformational Experience: Extensive experience in leading and executing transformational initiatives, driving change, and implementing innovative solutions to enhance organizational effectiveness and competitiveness.
* Proven Leadership Success: Demonstrated success in guiding and developing experienced leaders and their teams to maintain high levels of employee engagement.
* Large Team Management: Proven ability to successfully manage and lead large teams, ensuring alignment with organizational goals and fostering a high-performance culture.
* Outstanding Communicator: Highly effective written and verbal communication skills, including proficiency in developing and delivering presentations. Ability to tailor communication styles to different audiences, including internal cross-functional teams and external customers and partners.
* Strategic mindset: Proven abilities to develop and execute operational strategies aligned with the organization's goals and objectives. Aptitude for identifying trends, patterns, and operational bottlenecks to proactively address challenges and optimize processes.
* Analytical mindset: Thinks analytically with the ability to articulate complex ideas into clear frameworks; uses data to conduct root cause analysis and develops high quality, consumable, and consistent metrics that drive strategic objectives and priorities.
* Customer Centric: skilled at prioritizing the customers' needs and experiences, understanding what they want and delivering exceptional service.
* Has a thorough understanding of our industry, the relevant business landscape, and trends in growth and insurance environments; can spot early indicators of change and apply strategies to adapt quickly is required.
* Flexible and agile, comfortable with the ambiguity of a growing and transforming organization, skilled at working and building culture in remote environments.
Requirements:
* A bachelor's degree is required
* 15+ years of progressive experience in Operations Management roles including the areas of: Contact Center; Claims; Quality Assurance and Vendor Management are required.
* 10+ years of experience in people management, which includes leadership of leaders.
* Experience with financial management principles, including budgeting, cost control, and revenue generation. Experience in managing operational expenses while ensuring financial responsibility and achieving profitability targets is required.
* In-depth knowledge and experience in call center operations, including call management, queue management, and call routing strategies is required.
* Understanding of contact center metrics, such as Average Handle Time (AHT), First Call Resolution (FCR), Service Level Agreement (SLA), and Customer Satisfaction (CSAT) is required.
* Familiarity with call center technologies, including Automatic Call Distribution (ACD) systems, Interactive Voice Response (IVR) systems, and Computer Telephony Integration (CTI) is required.
* Proficiency in workforce management principles and tools to optimize staffing levels, scheduling, and forecasting is required.
* Proficiency in data analysis and interpretation to drive data-driven decision-making and operational improvements is required.
#LI-MS
#LI-REMOTE
What C&F will bring to you
* Competitive compensation package
* Generous 401K employer match
* Employee Stock Purchase plan with employer matching
* Generous Paid Time Off
* Excellent benefits that go beyond health, dental & vision. Our programs are focused on your whole family's wellness, including your physical, mental and financial wellbeing
* A core C&F tenet is owning your career development, so we provide a wealth of ways for you to keep learning, including tuition reimbursement, industry-related certifications and professional training to keep you progressing on your chosen path
* A dynamic, ambitious, fun and exciting work environment
* We believe you do well by doing good and want to encourage a spirit of social and community responsibility, matching donation program, volunteer opportunities, and an employee-driven corporate giving program that lets you participate and support your community
At C&F you will BELONG
If you require special accommodations, please let us know. We value inclusivity and diversity. We are committed to equal employment opportunity and welcome everyone regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status. If you require special accommodations, please let us know. Belonging at C&F, is a mindset. It's about fostering a culture of inclusion and connection, where everyone feels valued, heard, and empowered to thrive and where our social impact efforts help strengthen the communities where we live and work.
For California Residents Only: Information collected and processed as part of your career profile and any job applications you choose to submit are subject to our privacy notices and policies, visit **************************************************************** for more information.
Crum & Forster is committed to ensuring a workplace free from discriminatory pay disparities and complying with applicable pay equity laws. Salary ranges are available for all positions at this location, taking into account roles with a comparable level of responsibility and impact in the relevant labor market and these salary ranges are regularly reviewed and adjusted in accordance with prevailing market conditions. The annualized base pay for the advertised position, located in the specified area, ranges from a minimum of $200,000 to a maximum of $250,000. The actual compensation is determined by various factors, including but not limited to the market pay for the jobs at each level, the responsibilities and skills required for each job, and the employee's contribution (performance) in that role. To be considered within market range, a salary is at or above the minimum of the range. You may also have the opportunity to participate in discretionary equity (stock) based compensation and/or performance-based variable pay programs.
Responsibilities TII is dramatically transforming its customer and partner support services to simplify a customer's journey through their travel insurance plan experience. Our goal is to personalize each interaction through a set of omni-channel capabilities where customer questions are answered the first time, and their experience is backed up by a best-in-class experience rating. As the Vice President, Operations, TII, you will play a pivotal role in shaping and executing TII's operational strategy to achieve key performance and scalability goals. You will have the opportunity to lead by example, foster a culture of empathy and support, and drive operational excellence across our contact center, claims administration and quality assurance departments. This is an exciting opportunity for an accomplished operations leader to make a significant impact in transforming travel insurance experiences. Reporting to the President, TII, this is a crucial role in our organization for both day-to-day operational success as well as long-term operational strategy, planning, and optimization. This leader will be responsible not only for the performance of more than a hundred individuals on the team but also for the cross-functional partnership between operations and other departments at the company, including Sales, Account Management, Marketing, Product Management, Underwriting, Strategy, PMO, Continuous Improvement, IT, Compliance and HR/Training. The VP, Operations, will also build and leverage relationships with clients to achieve the goals of the company. The work will be fast paced with evolving needs, requiring flexibility, emotional intelligence, curiosity, and grace under pressure. As you onboard and assimilate to the role, TII, A&H and C&F, you can expect to roll up your sleeves to immerse yourself in the day-to-day work of the team to understand and impact continual improvement efforts. This role sits on our Senior Executive Leadership team and is a Leader of Leaders, with 4 direct reports. What you will do: - Oversee and lead Call Center, Claims, Quality Assurance and 3rd Party Vendor operational departments and functions which includes: omni-channel inbound customer service and sales, claims intake and customer service, claims adjudication, quality assurance programs for customer service and claims activities, appeal and complaint resolution, subrogation recovery activities, and third-party vendor management oversight. - Direct and lead an engaged workforce including customer experience, workforce planning, training and performance management. Provide coaching and mentorship to staff to foster talent and grow the organization. - Develop and oversee staffing plans to organizational budget for all functions and departments. - Collaborate cross functionally with Sales, Account Management, Marketing, Product Management, Underwriting, Strategy, PMO, Continuous Improvement, IT, Compliance, HR/Training, and other teams to achieve goals and partner on their planned initiatives. - Maintain operational excellence by implementing efficient processes, optimizing workflows, and leveraging technology to drive productivity and cost-effectiveness. - Skillfully develop and manage relationships with external clients and partners, in collaboration with Business Development and Account Management teams. - Carefully manage operational expense with an eye towards financial responsibility and company growth trajectory. - Provide management and oversight of third-party vendor relationships and services, including ongoing performance management, audits, contract renewals, RFPs and business reviews. Call Center: Customer Service, Inbound Sales, Partner Support Service, Claims Customer Service - Leads the development and execution of the service model including strategy, performance and employee engagement. - Develop and then execute a robust 3-5-year strategic roadmap to deliver market required capabilities, emerging contact center technologies, industry best practices and innovation to support customer growth and retention outcomes. - Execute roadmap to deliver enhanced self-service capabilities, increased revenue generating capacity (inbound service to sales optimization), and third-party augmentation. - Develop and implement new processes to incorporate digitally enabled services that encompass consumer value chain, from plan purchase to plan engagement to claims transactions. - Drive excellence in key service performance metrics, including ASA, abandonment rates, quality service scores, first call resolution, sales conversion and call center satisfaction. - Collaborate and coordinate efforts with IT to continuously assess and optimize the contact center infrastructure, including maintaining direct production support and configuration responsibilities for the IVR and ancillary enterprise telephony environment. - Oversee business readiness of new programs and technology in partnership with IT, Sales & Account Management, Marketing, Product and Operations. Claims Administration: First Notice of Loss (FNOL), Claims Intake Support, Adjudication - Create, communicate, and drive an aligned Claims strategy with emphasis on quality adjusting practices, process automation, and customer experience delivery. - Ensure effective management of all claims, processing service levels, and claims issues, provide quality management and technical oversight to ensure execution of the company's claims policies and philosophies. - Drive and facilitate planning and evaluation activities including budgets, forecasts, loss costs calculations, data analytics, setting and adjusting reserves, and effective risk transfer, as applicable - Exhibit keen understanding of travel insurance industry practices and trends, and of the competitive landscape. Quality Assurance: Auditing, Resolutions, Subrogation - Lead a team of Quality Assurance, Appeal and Complaint Resolution, and Subrogation professionals who manage and implement effective Quality Assurance programs for TII's customer service and claims operations. - Develop and execute the TII Quality Assurance strategy aimed at driving continuous process and talent improvement while delivering a return on QA resource investment. - Provide guidance to audit quality control framework and maintain compliance with audit methodology, while also operating within industry best practices, applicable regulations, and internal and external professional practice expectations. - Support strategic initiatives of the business as well as the larger corporate quality assurance, internal and external audit and compliance obligations. - Support the preparation of responses to regulatory and compliance inquiries, complaints, and examinations. - Other duties as required. What YOU will bring to C&F: - Transformational Experience: Extensive experience in leading and executing transformational initiatives, driving change, and implementing innovative solutions to enhance organizational effectiveness and competitiveness. - Proven Leadership Success: Demonstrated success in guiding and developing experienced leaders and their teams to maintain high levels of employee engagement. - Large Team Management: Proven ability to successfully manage and lead large teams, ensuring alignment with organizational goals and fostering a high-performance culture. - Outstanding Communicator: Highly effective written and verbal communication skills, including proficiency in developing and delivering presentations. Ability to tailor communication styles to different audiences, including internal cross-functional teams and external customers and partners. - Strategic mindset: Proven abilities to develop and execute operational strategies aligned with the organization's goals and objectives. Aptitude for identifying trends, patterns, and operational bottlenecks to proactively address challenges and optimize processes. - Analytical mindset: Thinks analytically with the ability to articulate complex ideas into clear frameworks; uses data to conduct root cause analysis and develops high quality, consumable, and consistent metrics that drive strategic objectives and priorities. - Customer Centric: skilled at prioritizing the customers' needs and experiences, understanding what they want and delivering exceptional service. - Has a thorough understanding of our industry, the relevant business landscape, and trends in growth and insurance environments; can spot early indicators of change and apply strategies to adapt quickly is required. - Flexible and agile, comfortable with the ambiguity of a growing and transforming organization, skilled at working and building culture in remote environments. Requirements: - A bachelor's degree is required - 15+ years of progressive experience in Operations Management roles including the areas of: Contact Center; Claims; Quality Assurance and Vendor Management are required. - 10+ years of experience in people management, which includes leadership of leaders. - Experience with financial management principles, including budgeting, cost control, and revenue generation. Experience in managing operational expenses while ensuring financial responsibility and achieving profitability targets is required. - In-depth knowledge and experience in call center operations, including call management, queue management, and call routing strategies is required. - Understanding of contact center metrics, such as Average Handle Time (AHT), First Call Resolution (FCR), Service Level Agreement (SLA), and Customer Satisfaction (CSAT) is required. - Familiarity with call center technologies, including Automatic Call Distribution (ACD) systems, Interactive Voice Response (IVR) systems, and Computer Telephony Integration (CTI) is required. - Proficiency in workforce management principles and tools to optimize staffing levels, scheduling, and forecasting is required. - Proficiency in data analysis and interpretation to drive data-driven decision-making and operational improvements is required. #LI-MS #LI-REMOTE
Auto-ApplyOperations Senior Supervisor -Express Scripts
Saint Louis, MO jobs
The Operations Senior Supervisor is responsible for day-to-day operations of a team of technicians, pharmacists and contract workers. Manages and improves productivity and performance standards, plans and directs workflow and project assignments. Responsible for attaining or exceeding production goals for their respective area daily. Conducts hiring, training, and evaluation of front-line team members. Responsible for team's adherence to employment policies and corporate values. Works with the Pharmacy senior leadership team to establish team and site standards and expectations, operational processes and procedures, and the business work plan for the team. Recognizes and recommends operational improvements.
Work Schedule: Shift will be Mon - Thurs 3:30pm - 2:00am
Location: 4600 North Hanley Road; St. Louis, MO 63134
What you will do:
Develop, track and monitor employee's safety, compliance to quality, service and production standards.
Monitor prescription turnaround time so that internal standards and client performance guarantees are met.
Assist Pharmacy senior leadership team in monitoring costs to ensure compliance with cost to fill goals.
Address staff concerns and day to day operational, system, customer service, quality, and professional issues.
Work in production as needed.
Implement programs and process improvements to enhance the level of internal and external customer service provided.
Work with Pharmacy senior leadership team to analyze operations and overall efficiencies of the pharmacy.
Serve as a point of escalation for issues requiring a higher degree of expertise or discretion to resolve.
Represents pharmacy operations in cross-functional meetings and projects.
Other special projects and tasks as assigned.
What you will need:
High school diploma or GED
BA/BS degree preferred.
Minimum of two years operations experience (i.e., pharmacy, warehouse, distribution, production, manufacturing, or engineering)
Must be eligible to maintain a pharmacy technician license issued through the Missouri State Board of Pharmacy throughout time in position.
Demonstrated leadership skills and the ability to effectively develop, train and coach less experienced team members; supervisory experience preferred.
Knowledge of lean or process improvement methodologies
Excellent oral and written communication skills
Ability to adapt in a dynamic work environment, make independent decisions.
Advanced problem-solving skills and the ability to work collaboratively with other departments to resolve complex issues with innovative solutions.
Willingness to work a flexible schedule for peak times.
Monitors daily operations of a unit and actively assists or provides direction to subordinates as required.
May perform, especially in staff or professional groups ongoing operational tasks of organization units (typically not more than 40% of time performing the work supervised)
Ensures that projects are completed on schedule following established procedures and schedules.
General PC knowledge including Microsoft Office, Internet, and email.
Why join us?
Health coverage effective day 1 (including medical, dental, vision)
Holiday Pay and Paid Time Off (PTO)
401K with company match
Tuition reimbursement
Growth Opportunities
Fun, friendly and unique culture - bring your whole self to work every day!
This is an onsite position.
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
About Evernorth Health Services
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
Auto-ApplyVice President of Operations - Remote
Remote
Are you looking to accelerate your career without having to hide your authentic self - a place where you can be you? A career that's making a bigger impact on the world? At OneDigital, we are on a mission to help people do their best work and live their best lives. From the services we offer to the way we show up for each other each day, we are fueling dreams, achieving big goals, and embracing each other's truest selves.
We understand that pursuing a new job is a big deal. Maybe you're afraid you won't fit in. Well, here's the good news. For us, the days of “fit in to get in” are over and being different is not a barrier to getting ahead. Greatness comes in all shapes, sizes, colors, and experience levels. If you are looking for a people-first culture that is wired for growth, driven to serve, and totally committed to having your back, give us a shot. Your best life awaits.
Must be eligible to work in the United States without the need for work visa or residency sponsorship.
Our Newest Opportunity:
The Vice President of Operations is responsible for driving operational excellence, scalability, and cross-functional alignment across the Pharmacy Consulting Practice at RxConnections / OneDigital. This leader will address current departmental challenges-such as siloed teams, manual processes, and resource constraints-while capitalizing on opportunities for automation, integration, and growth with a significant focus on the adoption and application of the best available technology and AI. The mission is to ensure RxConnections delivers differentiated, high-value client solutions through efficient, collaborative, and innovative operations.
Reporting Structure
Reports directly to the Chief Clinical Officer, Jeff Post.
Oversees the Account Management, Data & Analytics, PBM RFP, and Audit teams.
Works in close partnership with the VP of Clinical Services.
Teams Overseen
Account Management: Client implementation, client renewals, CRM maintenance, reporting delivery, and client engagement.
Data & Analytics: Reporting creation, benchmarking creation, analytics suite creation and modernization, and data-driven insights.
PBM RFP: RFP process management, automation, and vendor evaluation.
Audit: Audit process execution, expansion, and integration with broader consulting services.
Primary Responsibilities & Operational Priorities Aligned to Departmental Issues & Opportunities:
Break down silos and foster cross-team collaboration through structured leadership meetings, shared goals, and actionable outcomes.
Lead process automation initiatives (RFP, reporting, contract review) to reduce manual work, eliminate bottlenecks, and improve scalability.
Develop and implement a unified CRM and project management system to streamline operations and enhance visibility.
Address resource constraints by advocating for scalable staffing models, capacity planning, and targeted hiring-especially in account management and analytics.
Modernize client reporting and analytics, introducing enhanced benchmarking, improved UI/UX, and client portals to maintain competitive differentiation.
Drive integration with OneDigital, unifying branding, technology, and client engagement for a cohesive market offering.
Establish and monitor operational KPIs, ensuring continuous improvement and accountability across all teams.
Champion a culture of transparency, innovation, and client-centricity.
Cross-Functional Partnership Expectations
Collaborate closely with the VP of Clinical Services to align operational and clinical strategies, ensuring seamless client delivery and innovation.
Work with OneDigital teams to drive business integration, cross-selling, and resource sharing.
Required Qualifications, Experience & Core Competencies
Bachelor's degree in business, healthcare, or related field.
10+ years of progressive leadership experience in healthcare consulting, pharmacy benefit management, or related operations.
Demonstrated success in leading multi-disciplinary teams and managing complex, cross-functional projects.
Proven track record in process improvement, automation, and technology adoption.
Strong analytical, strategic planning, and change management skills.
Excellent communication, stakeholder management, and team-building abilities.
Experience with CRM, project management, and reporting/analytics tools.
Commitment to people-first leadership, transparency, and continuous improvement.
Performance Metrics / KPIs & Success Criteria
Reduction in manual processes and operational bottlenecks (e.g., % of automated RFPs, reporting cycles).
Improved cross-team collaboration and employee engagement scores.
Client satisfaction and retention rates.
Timeliness and quality of client deliverables (reporting, audits, RFPs).
Achievement of departmental growth targets and profitability.
Staff turnover and capacity utilization metrics.
Implementation of succession plans and leadership development initiatives.
Leadership Expectations & Stakeholder Management
Act as a mentor and motivator, holding teams accountable while fostering professional growth.
Drive a culture of innovation, transparency, and operational excellence.
Provide clear direction, set non-negotiables, and communicate priorities.
Build strong relationships with internal and external stakeholders, including clients, vendors, and OneDigital partners.
Lead by example in breaking down silos, promoting organizational thinking, and aligning teams to a common purpose.
The typical base pay range for this role nationwide is $160,000 to $210,000 per year.
Your base pay is dependent upon your skills, education, qualifications, professional experience, and location. In addition to base pay, some roles are eligible for variable compensation, commission, and/or annual bonus based on your individual performance and/or the company's performance. We also offer eligible employees health, wellbeing, retirement, and other financial benefits, paid time off, overtime pay for non-exempt employees, and robust learning and development programs. You will receive reimbursement of job-related expenses per the company policy and may receive employee perks and discounts.
To learn more, visit: **************************
OneDigital is an equal opportunity employer. Not only as a matter of standard, but to honor and celebrate our differences. We believe that the power of ONE starts with you. We are committed to cultivating and preserving a culture that celebrates diversity, insists on equity and inclusion, and connects us. Ensuring our people feel seen, valued, respected, and supported is fundamental to our core values and business goals.
OneDigital provides equal employment opportunities to all employees and applicants for employment regardless of their: veteran status, uniformed servicemember status, race, color, religion, sex, sexual orientation, gender identity, age (40 and over), pregnancy (including childbirth, lactation and related medical conditions), national origin or ancestry, citizenship or immigration status, physical or mental disability, genetic information (including testing and characteristics) or any other category protected by federal, state or local law (collectively, “protected characteristics”). A copy of the Federal EEO poster is linked here.
Pursuant to local Fair Chance Ordinances, we will consider qualified applications with arrest or conviction records for employment. For applicable candidates, the following ordinances are linked here to inform you of your rights as an applicant:
City and County of San Francsico
City of Los Angeles
County of Los Angeles
Employment decisions shall comply with all other applicable federal, state and city/county laws prohibiting discrimination in employment. OneDigital complies with all criminal history inquiry [or ‘ban the box'] laws in California, Connecticut, Colorado, Hawaii, Illinois, Maine, Maryland, Massachusetts, Minnesota, New Jersey, New Mexico, Oregon, Rhode Island, Vermont and Washington.
In short, we believe in hiring the most qualified applicant for the position, regardless of background.
If you have questions about our hiring policies and practices, we would be happy to discuss upon receiving your application. We hope to welcome you to OneDigital and look forward to hearing from you.
OneDigital understands the immense responsibility and opportunities provided by Artificial Intelligence. We utilize advanced Artificial Intelligence [AI] technologies to enhance our recruitment process. This includes using AI to filter candidates based on their qualifications and to rediscover potential candidates from our existing applicant pool. Our AI systems help us efficiently identify the best fit for our open positions, ensuring a streamlined and effective hiring experience. However, AI does not replace the humans in our process. If you have concerns about our use of AI, you may opt out where laws allow.
OneDigital understands the immense responsibility and opportunities provided by Artificial Intelligence. We utilize advanced Artificial Intelligence [AI] technologies to enhance our recruitment process. This includes using AI to filter candidates based on their qualifications and to rediscover potential candidates from our existing applicant pool. Our AI systems help us efficiently identify the best fit for our open positions, ensuring a streamlined and effective hiring experience. However, AI does not replace the humans in our process. If you have concerns about our use of AI, you may opt out where laws allow.
Thank you for your interest in joining the OneDigital team!
Auto-ApplyVP Disability & Leave Operations
Remote
Lead Disability & Leave Operations-Work from Anywhere in the US!
VP, Disability & Leave Operations | Remote
As a VP Disability &Leave Operations, you'll oversee services like STD, FMLA, LTD, and absence management while refining strategies for an exceptional employee experience and cost-effective operations. You'll drive best practices, educate clients, and ensure efficient processes that align with business goals. If you're a strategic leader passionate about operational excellence, this is your opportunity to make an impact.
If you're a strategic leader passionate about operational excellence and shaping processes that align with business goals, this is your chance to lead from anywhere.
Apply today and redefine the future of absence management!
Bachelor's Degree or equivalent work experience required.
Minimum of eight years progressive experience in managing integrated disability and absence management programs with preference for employer-based experience
Six years in a supervisory or leadership capacity required
Expertise with IDAM best practice benchmarking and metrics
Demonstrated ability to establish critical relationships at all levels of the organization and with external partners
Exceptional communication skills, change management skills, and customer focus
Strong organizational and time management skills
Excellent oral, written, and presentation skills
Demonstrated experience in building high performance teams - ability to inspire a shared vision and empower and motivate a team. Desired:
Experience in a broader integrated health and productivity model including healthcare, on-site clinics, wellness, and EAP
Experience with middle to large complete company e.g. 7,000 + employees, union representation and industrial, highly physically demanding jobs.
Licensed disability adjuster
Desired:
Current membership/leadership in professional organization critical to the field
Must complete continuing education requirements as outlined by Crawford Educational Services
Nationally accredited certification in a related profession such as Certified Disability
Management Specialist (CDMS) or Certified Case Manger (CCM)
#LI-DV1
Facilitates the implementation, continuous improvement and integration of all disability and absence management programs/processes within the unit.
Provides proactive leadership in developing a continuous improvement culture within the IDAM department. Ensures that all aspects of the department's operations are meeting corporate guidelines, federal, state, and local law and are in accordance with professional standards and confidentiality. Concurrently, assessing the various programs ensuring they meet their defined objective and are meeting the needs of our clients.
Manages, hires, trains, develops and motivates qualified individuals.
Maintains up-to-date knowledge of industry trends in integrated disability and absence management to ensure that the various programs and processes are truly best practice.
Manages business unit to budget to meet corporate revenue objectives.
Communicates P&L performance and positive/negative trends to executive management.
Prepares budget forecasts as well as periodic re-forecasts as required.
Works with the reporting and analytics team to ensure our key metrics are current and measures that allow a view of the day to day efficiency and effectiveness of the operations as well as the higher level business impact that can be benchmarked.
Participates in sales presentations and meetings with prospects and current accounts in support of corporate revenue objectives.
May participate in the appeals process.
Performs other related duties as required.
Auto-ApplyBusiness Operations Manager
Remote
The Business Operations Manager is a key role responsible for ensuring the smooth operation of day-to-day business activities. This role involves coordinating with various departments, managing resources, improving performance, procuring material and resources, and securing compliance.
What will your job entail?
Job Responsibilities:
• Manage staff performance and development for a shared services policy operations team.
• Monitor productivity volume, service standards and accuracy for their staff and the business that they support.
• Troubleshoot errors or issues to ensure that the business is processed in a timely manner, taking action to resolve any roadblocks.
• Troubleshoot errors or issues to ensure that the business is processed in a timely manner, taking action to resolve any roadblocks.
• Interact with both clients and management to ensure efficient and effective processing and work to address errors and concerns.
• Drive process improvement and innovation efforts to continually improve our services for the businesses that we support.
• Ensure proper documentation of processes and procedures for all internal functions and the services delivered to our customers.
• Communicate effectively with management, underwriters and brokers to secure the information necessary to accurately process the business.
• Provide timely and efficient service to all internal and external customers, including underwriters and brokers.
• Mentor and train staff and drive performance management and staff development efforts.
• Communicate effectively with the senior leadership of the businesses that we support and promptly respond to any issues that may rise.
• Create and distribute routine and ad-hoc reports as assigned.
• Participate in or handle special projects, as needed.
• Collaborates with resources across the organization to pursue continual process optimization and innovation.
Work Experience and Education Requirements:
• Strong knowledge of the Property & Casualty insurance industry as well as insurance terminology and the commercial insurance policy lifecycle required*
• BA/BS degree in business and/or a technology related field preferred.
• 6+ years of experience in a business operations environment with insurance experience and experience with core business systems and applications preferred. Property and casualty and MGA/MGU experience highly preferred.
• 3+ years of experience managing staff and workflow in a fast-paced business environment.
Licenses & Certifications:
• State P & C License a required.
• Lean Six Sigma a plus.
Skills:
• Knowledge Of Insurance Industry
• Lean Tools and Techniques
• Management/Leadership
• Operations Management
• Business Relationship Management
• Process Improvement
• Mentor/Coaching
• Ad hoc Reporting
Behavioral Skills:
• Problem Solving
• Team Management
• Organizational
• Attention to Detail
• Time Management
• Communication
• Collaborative
Ryan Specialty is an Equal Opportunity Employer. We are committed to building and sustaining a diverse workforce throughout the organization. Our vision is an inclusive and equitable workplace where all employees are valued for and evaluated on their performance and contributions. Differences in race, creed, color, religious beliefs, physical or mental capabilities, gender identity or expression, sexual orientation, and many other characteristics bring together varied perspectives and add value to the service we provide our clients, trading partners, and communities. This policy extends to all aspects of our employment practices, including but not limited to, recruiting, hiring, discipline, firing, promoting, transferring, compensation, benefits, training, leaves of absence, and other terms, conditions, and benefits of employment.
How We Support Our Teammates
Ryan Specialty seeks to offer our employees a comprehensive and best-in-class benefits package that helps them - and their family members - achieve their physical, financial, and emotional well-being goals. In addition to paid time off for company holidays, vacation, sick and personal days, Ryan offers paid parental leave, mental health services and more.
The target salary range for this position is $104,000.00 - $130,000.00 annually.
The wage range for this role considers many factors, such as training, transferable skills, work experience, licensure and certification, business needs, and market demands. The pay range is subject to change and may be modified in the future. Full-time roles are eligible for bonuses and benefits. For additional information on Ryan Specialty Total Rewards, visit our website *****************************
We provide individuals with disabilities reasonable accommodations to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment in accordance with applicable law. Please contact us to request an accommodation at *************
The above is intended to describe this job's general requirements. It is not to be construed as an exhaustive statement of duties, responsibilities, or physical requirements. Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.
Auto-ApplyManager, Business Operations
Remote
About Us:
Judi Health is a health technology company offering a wide range of benefits administration solutions for employers and health plans. This includes Capital Rx, a public benefit corporation that provides full-service pharmacy benefit management (PBM) solutions to self-insured employers; Judi Health™, which offers comprehensive health benefit management solutions for employers, TPAs, and health plans; and Judi , the industry's leading proprietary Enterprise Health Platform. To learn more, visit ****************
Location: Remote (For Non-Local) or Hybrid (Local to NYC area)
Position Summary:
Capital Rx is seeking a Manager, Business Operations to join our growing Judi Care navigation team. This role is ideal for someone with 2-4 years of experience in startup BizOps, Consulting, or Finance who thrives in fast-moving environments, enjoys tackling a wide variety of challenges, and is looking to build a foundation for long-term leadership opportunities. You'll contribute directly to both external growth efforts and internal strategy, balancing hands-on execution with analytical problem-solving.
Position Responsibilities:
Sales Channel Management
Manage and optimize sales channels to ensure effective distribution of Judi Care services.
Develop and implement sales strategies that drive revenue growth and expand our customer base.
Work closely with the Sales team to ensure alignment with partnership and channel strategies.
Market Trend Analysis
Identify and analyze market trends that impact the sales and distribution of care navigation services.
Stay informed about industry developments, competitive landscape, and customer needs to ensure our offerings remain relevant and competitive.
Provide insights and recommendations to the Marketing and Product teams to refine strategies and offerings.
Minimum Qualifications:
Bachelor's degree.
2-4 years of experience in business operations, consulting, or finance.
Demonstrated ability to manage projects, analyze data, and synthesize insights into actionable recommendations.
Excellent communication skills, with confidence presenting to both internal and external stakeholders.
Highly adaptable, resourceful, and motivated to contribute in a dynamic, growth-oriented environment.
Strong problem-solving skills and a balance of structured thinking with hands-on execution.
Responsible for adherence to the Capital Rx Code of Conduct, including reporting of noncompliance.
Salary Range$110,000-$130,000 USD
This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.
Judi Health values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
Auto-ApplyVP, Dental Operations (ACS Benefit Services)
North Carolina jobs
We are seeking a Vice President of Dental Operations to join the team at ACS Benefit Services, one of our subsidiary companies. The Vice President, Dental is responsible for the development, oversight, and execution of all dental operations, including claims adjudication, customer service, appeals, and reporting. This role provides strategic leadership and overall management of the dental line of business, driving product strategy, operational performance, and growth while ensuring a high-quality client and member experience.
Candidate must reside in one of the following states: FL, GA, IN, KS, NC, SC, VA
What You'll Do
Advise and assist management on all matters regarding Dental strategy for growth
Ensure the department meets monthly performance metrics and reporting requirements, including those established by our large dental client, and oversee ongoing training, documentation, and related operational needs. Implement cross-training within the department to maintain continuity of operations during team absences. Ensure operation requirements are accurately documented and regularly updated
Participate in weekly and monthly meetings with large dental carrier to review dental strategy and address any product related issues
Meet at least quarterly with vendors to review performance, business processes, and opportunities for improvement
Lead all aspects of management for direct reports including hiring, onboarding, coaching, performance management, and corrective actions up to and including terminations
Conduct consistent one-on-one check-ins with direct reports and facilitate effective team meetings to drive alignment, communication and accountability
Work closely with the Senior Eligibility Technician, providing support as needed to ensure operational accuracy and continuity. Ensure consistent, transparent communication with Management regarding the coordination and implementation of all dental and ancillary operations.
Partner with IT to establish and document procedures for assimilating business into the dental system and enhancing reporting capabilities.
What You Bring
Bachelor's Degree in Business or related field, preferred; or 10 or more years related experience may be considered in lieu of degree
5 or more years related experience
Strong leadership presence with the ability to set direction, drive accountability, and develop high-performing teams.
Proven ability to manage workflows, optimize processes, and oversee training, development, and scheduling across multiple functions.
Deep working knowledge of dental operations, including claims adjudication, customer service, appeals, and audit requirements.
Familiarity with ancillary products (COBRA, Stop-Loss, HSA/FSA, HDHP) and their operational, regulatory, and compliance considerations a plus.
Proficient in Microsoft Office applications-including Word, Excel, PowerPoint, and Outlook-with the ability to interpret and present data.
Excellent verbal and written communication skills with strong presentation capabilities for internal leadership and clients.
Highly organized with the ability to lead complex projects through completion while balancing competing priorities.
Demonstrated ability to motivate and influence teams and cross-functional partners to achieve shared goals.
Strong critical thinking skills with the capacity to evaluate issues, identify solutions, and make sound business decisions.
Ability to innovate beyond standard processes and think strategically to support operational improvements and new product capabilities.
Comfortable working under pressure, meeting tight deadlines, and navigating ambiguity.
Committed to delivering an exceptional customer experience for both internal and external stakeholders.
Physical Demands and work environment:
This is largely a sedentary role. This role routinely uses standard office equipment such as computers and phones. This role may be performed in a professional office environment or a Work-from-Home environment. Work-from-Home environment requires a dedicated workspace with minimal distractions.
Benefits:
ACS strives to be a preferred employer in the Piedmont Triad area of North Carolina. Just as we focus on being accessible, caring, and trustworthy providers of our TPA services, we want to provide a work environment that mirrors those values. ACS Benefit Services provides our employees with numerous benefits including:
Medical, Dental, Flexible Spending Plans
Retirement plans - including 401(k) with generous employer match
Educational opportunities
Opportunities for advancement
Encouragement for a work/life balance
#LI-DNI
Salary Range
At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.
*Based on annual corporate goal achievement and individual performance.
Skills
Auto-ApplyFormulary Operations Manager - Exchange
Remote
About Judi Health
Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including:
Capital Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers,
Judi Health™, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and
Judi , the industry's leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform.
Together with our clients, we're rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve. To learn more, visit ****************
Position Summary:
The Formulary Operations Manager is responsible for providing operational support for the evaluation, implementation, and maintenance of our standard and custom Commercial and Exchange formularies and utilization management. This individual supports the creation and maintenance of formulary, clinical adjudication list, and utilization management lists, preparation of Exchange JSON formulary submission files and member formulary drug lists, preparation and review of updates for implementation, and other formulary and utilization management related tasks and processes. The role requires strong cross functional collaboration and communication skills, and an understanding of formulary operations processes.
Position Responsibilities:
Define, configure, and maintain standard and custom formularies for the Commercial and Health Information Marketplace/Exchange lines of business
Provide client-facing strategic and operational support for the configuration, implementation, maintenance, and quality control of custom formularies, drug lists, custom formulary marketing materials, clinical adjudication lists, and utilization management edits
Evaluate appropriateness and operationalize custom client formulary and benefit requests within the formulary / adjudication platform
Collaborates with teams in a cross-functional environment including, but not limited to; benefit administration, rebate administration, client account management, analytics, software development/product, regulatory/compliance, government programs, member experience, prior authorization operations, and marketing
Develop weekly drug product review and formulary recommendations by assessing drug use trends, new drug releases, and review of primary literature
Analyze pharmacy cost of care, clinical updates, and coordinate the development of appropriate formulary management programs and utilization management edits
Set criteria for medication analysis and coordinate methodology for client requested and regulatory formulary reporting requirements
Evaluate drugs/drug classes and make formulary positioning and utilization management recommendations and formulary management strategies and associated adjudication requirements to operationalize
Provide cross functional support for claim troubleshooting within the adjudication platform
Support comprehensive testing of client formulary and benefit elections
Support formulary change processes within URAC/NCQA/SOC guidelines and requirements
Support client formulary requests, as required
Support quality improvement projects, as required
Support the Capital Rx pharmaceutical pipeline, as needed
Support Request for Information (RFI) and Request for Proposal (RFP) submissions, as needed
Support general business needs and operations, as required
Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance
Minimum Qualifications:
Doctor of Pharmacy (PharmD) Degree from an accredited institution, with record of strong academic performance
Current, unrestricted registered pharmacist license(s)
Residency/fellowship preferred
2-3 years of formulary experience working for a health plan or PBM preferred
2-3 years of Medicare experience preferred
Knowledge of formulary development and maintenance processes
Knowledge of highly managed specialty medications/strategy
Knowledge of rebate and financial implications of formulary strategies
Experience working with large datasets preferred
Ability to independently identify, research, and resolve issues
Ability to balance multiple complex projects simultaneously
Ability to work extended hours, weekends, and holidays consistent with industry demands
Exceptional written and verbal communication skills
Extremely flexible, highly organized, and able to shift priorities easily
Attention to detail & commitment to delivering high quality work product
Microsoft office suite with emphasis on Microsoft excel proficiency required
This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.
Salary Range$135,000-$145,000 USD
All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.
Judi Health values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at *********************************************
Auto-ApplyBusiness Manager - Extended Service Agreements
Charlotte, NC jobs
Join us to create change and have an impact in homes around the world.
At Electrolux, a leading global appliance company, we strive every day to shape living for the better for our consumers, our people, and our planet. We share ideas and collaborate so that together, we can develop solutions that deliver enjoyable and sustainable living.
Come join us as you are. We believe diverse perspectives make us stronger and more innovative. In our global community of people from 100+ countries, we listen to each other, actively contribute, and grow together.
Where you'll be:
This position will be based in the Charlotte, NC HQ; hybrid work policy model.
All About the Role:
The Business Manager, Extended Service Agreements (ESA), plays a critical role in driving operational and financial success for the ESA business. This position oversees end-to-end program management, ensuring seamless execution and alignment with strategic goals. The role requires strong analytical skills, business acumen, and the ability to collaborate across Finance, Sales, Marketing, Legal, IT, and Service teams. Success depends on excellent communication, problem-solving, and adaptability in a fast-paced environment.
Key Responsibilities:
Manage day-to-day ESA operations to achieve revenue and profitability targets aligned with strategic objectives
Oversee end-to-end ESA processes, including claims monitoring, performance evaluation, and timely resolution
Collaborate with Sales, Marketing, and Customer Service to drive lead generation, improve conversion rates, and grow program enrollment
Develop and implement promotional strategies and pricing models in partnership with Finance and Marketing teams
Streamline operations and implement best practices to enhance efficiency, accuracy, and customer experience
Support financial planning and reporting, including forecasting, budgeting, and variance analysis
Maintain vendor relationships and oversee contract negotiations, service level agreements, and compliance standards
Conduct market and competitive analysis to identify trends, opportunities, and risks, informing strategic decisions
Lead cross-functional projects and initiatives to improve ESA performance and deliver on business transformation goals
Minimum Qualifications
Bachelor's degree
4+ years of experience with warranty, insurance, claims processing, and financial systems preferred
Advanced proficiency in Microsoft Office (Excel, PowerPoint, Word) and CRM systems
Ability to manage sensitive information and prioritize multiple projects in a fast-paced environment
Benefits highlights:
Discounts on our award-winning Electrolux products and services
Family-friendly benefits
Insurance policy plan
Extensive learning opportunities and flexible career path
Please be advised that we are unable to offer visa sponsorship for this position at this time.
Find more on: Electrolux Group North America:
************************************************************** Electrolux Group Careers: ********************************************
Electrolux Consumer Products, Inc. is an Equal Opportunity Employer (EOE). Qualified applicants are considered for employment without regard to age, race, color, religion, sex, national origin, sexual orientation, disability, or veteran status. If you need assistance or an accommodation during the application process because of a disability, it is available upon request through ******************************. The company is pleased to provide such assistance, and no applicant will be penalized as a result of such a request.
#LI-OG1
Auto-ApplyNY Workers' Compensation Operations Manager
Remote
Oversee and ensure the overall profitability of the regional operations center. This position oversees our New York Division and services New York Workers' Compensation claims organizations.
This includes but is not limited to reaching and exceeding financial & referral goals, properly managing staffing efficiencies throughout the team, managing performance expectations & improvements for existing staff. Present management with regular reporting on any topic requested by the management team.
Dane Street's success relies on individual and team contributions every day. We care for our customers, each other and Dane Street. It is the responsibility for all of us to maintain a positive working environment that promotes client satisfaction and results.
MAJOR DUTIES & RESPONSIBILITIES
Responsible for client satisfaction of New York Workers' Compensation clients.
The position requires 5-10 years of NY WC claims experience or the equivalent experience servicing NY WC Claims organizations for an IME Entity in a leadership position
The ideal candidate will possess knowledge of all applicable NY WC IME and record review laws and regulations
The ideal candidate should have an understanding of the NY WC claims landscape, including but not limited to:
Insurance Carriers
Third-Party Administrators
Self-Insured entities
Insurance Defense Firms
State and Local entities
Driving Revenue Growth
The Operations Manager drives revenue growth by delivering excellent Customer service, which includes:
Meeting scheduling best practices and turnaround time requirements.
Ensuring the timely delivery of high-quality reports.
Managing client inquiries in a timely manner.
Optimizing Physician cost
Ensuring that client invoices adhere to the agreed-upon fee schedule.
Overseeing the proper selection of physicians.
Specifically, ensuring that the team selects the most appropriate physician based on the claimant's location, the required specialty, and the most appropriately priced physician based on the client's fee schedule.
Building and maintaining relationships with key physicians to ensure panel retention, preferred availability, and monthly block-time scheduling.
Manage Staff Performance and capacity
Monitor key performance metrics of individual Customer Service Representatives (CSR) and Quality Assurance (QA) Specialists.
Ensure the team meets or exceeds 85% of output goals for scheduling and Quality Assurance targets.
Responsible for hiring new staff members based on increased referral volume and/or the addition of new clients.
Conducts performance evaluations that are timely and constructive.
Handles discipline and termination of employees as needed and in accordance with company policy.
Client Interaction
Collaborates with the Sales team as a primary liaison to ensure client needs are understood and addressed effectively.
The Operations Manager may be requested to join the Sales staff for client calls/meetings on an as-needed basis.
Responsible for the overall production, performance, and quality of the assigned region.
Plans and organizes daily activities related to production and operations.
Measures productivity by analyzing performance data, financial data, and activity reports.
Coordinates with other support departments such as human resources, finance, and IT and BA to ensure successful production operations.
Determines labor needs to meet production goals.
Oversee the deposition process at the request of the client or defense counsel.
Other duties & special projects, as assigned and based on business needs.
Requirements
EDUCATION/CREDENTIALS:
An Associate's Degree or Bachelor's Degree is preferred.
JOB RELEVANT EXPERIENCE:
Business experience in a healthcare and/or insurance setting is preferred.
Business experience in a Worker's Compensation and/or Auto insurance setting is preferred.
NY IME experience preferred.
JOB RELATED SKILLS/COMPETENCIES:
Present exceptional communication skills with a clear understanding of company business lines. The ability to apply critical thinking, manage time efficiently and meet specific deadlines. Computer literacy and typing skills are essential.
WORKING CONDITIONS/PHYSICAL DEMANDS:
Any lifting, bending, traveling, etc. required to do the job duties listed above. Long periods of sitting and computer work.
WORK FROM HOME TECHNICAL REQUIREMENTS:
Supply and support their own internet services.
Maintaining an uninterrupted internet connection is a requirement of all work from home position.
This job description is subject to change at any time.
Benefits
We offer generous Paid Time Off, excellent benefits package and a competitive salary. If you want to work in an exciting, fast-paced environment where you can provide meaningful contributions, then we encourage you to apply.
ABOUT DANE STREET:
A fast-paced, Inc. 500 Company with a high-performance culture, is seeking insightful, astute forward-thinking professionals. We process over 200,000 insurance claims annually for leading national and regional Workers' Compensation, Disability, Auto and Group Health Carriers, Third-Party Administrators, Managed Care Organizations, Employers and Pharmacy Benefit Managers. We provide customized Independent Medical Exam and Peer Review programs that assist our clients in reaching the appropriate medical determination as part of the claims management process.
Join our team at Dane Street and enjoy a comprehensive benefits package designed to support your well-being and peace of mind. We offer a range of benefits including medical, dental, and vision coverage for you and your family. Additionally, we offer voluntary life insurance options for you, your spouse, and your children. We also offer other voluntary benefits which include hospital indemnity, critical illness, accident indemnity, and pet insurance plans. Employees receive basic life insurance, short-term disability, and long-term disability coverage at no cost. Our generous paid time off policy ensures you have time to relax and recharge, while our 401k plan with a company match helps you plan for your future. Apple equipment and a media stipend are provided for remote workspace.
ABOUT DANE STREET:
A fast-paced, Inc. 500 Company with a high-performance culture, is seeking insightful forward-thinking professionals. We process over 200,000 insurance claims annually for leading national and regional Workers' Compensation, Disability, Auto, and Group Health Carriers, Third-Party Administrators, Managed Care Organizations, Employers, and Pharmacy Benefit Managers. We provide customized Independent Medical Exams and Peer Review programs that assist our clients in reaching the appropriate medical determination as part of the claims management process.
Auto-ApplyOperations Manager
Phoenix, AZ jobs
The Operations Manager plays a critical role in overseeing the daily operations of the organization, ensuring that processes run smoothly and efficiently. This position requires a strategic thinker with strong leadership capabilities who can manage teams effectively while driving business growth and operational excellence. The ideal candidate will be responsible for implementing process improvements, managing projects, and contributing to the overall success of the organization. A requirement of at least 5 years of experience is preferred.
Duties
- Lead and supervise operational teams to achieve performance goals and enhance productivity.
- Develop and implement strategic plans to improve operational efficiency and effectiveness.
- Oversee project management initiatives to ensure timely completion and adherence to quality standards.
- Analyze profit and loss statements to identify areas for improvement and drive profitability.
- Foster a culture of continuous improvement by identifying opportunities for process enhancements.
- Collaborate with other leadership to help cultivate and development teams.
- Ensure compliance with company policies
Skills
- Strong leadership skills with the ability to motivate and manage diverse teams.
- Proven experience in supervising staff and managing day-to-day operations.
- Excellent project management skills, with a focus on delivering results on time and within scope.
- Demonstrated ability in process improvement methodologies to enhance operational workflows.
- Knowledge of sales strategies and business development practices that drive growth.
- Proficiency in analyzing financial data, including profit loss statements, to inform decision-making.
- Strategic planning capabilities that align operational objectives with organizational goals.
- Strong communication skills, both verbal and written, for effective collaboration across departments.
Qualifications
Bachelor's degree in Operations Management, Business Administration, or a related field
Minimum of 3 years of experience in operations management or a related role
Proven track record of successfully managing large-scale projects
Strong leadership and communication skills
Ability to work collaboratively with cross-functional teams
Knowledge of project management software and tools
Experience in budgeting and financial management
This Operations Manager position is ideal for individuals who are passionate about driving operational success while leading teams toward achieving common goals. You will work Remotely and have full sponsor on company visits twice a week. If you possess the necessary skills and experience, we encourage you to apply.
Permitting Operations Manager (Mid-level / Senior Architect)
Washington, DC jobs
Our Company:InterAgency Inc.is a minority-owned DC-based small business specializing in environmental planning and permitting. Since 2011, InterAgency has helped water, wastewater, and transportation agencies navigate the regulatory process for some of the largest infrastructure projects in the DC Metro region.
Description: InterAgency is seeking a versatile, experienced architectural professional to manage permitting operations on behalf of a major water and wastewater utility client. This hybrid, client-facing role combines elements of project management, stakeholder engagement, and permit management. The successful professional will act as a key liaison between the client, internal teams, and external regulatory agencies to ensure timely permit approvals and smooth coordination. Ideal candidates are architects ready to transition from a traditional architectural role into a consulting and project management role with improved work-life balance.
Responsibilities:
Submitting permit applications via online portals for Client projects to regulatory agencies (DDOT, DOB, DOEE, etc.).
Reviewing permit submission documents for compliance with all Federal and local regulatory requirements.
Tracking status of ongoing permits and providing Client and InterAgency project managers with regular updates regarding permit comments, responses, and issues.
Ensuring that permit applications remain current and active, and facilitating Clients payment of invoices in a timely manner.
Advising Client and contractors on best practices for pursuing permit applications and negotiating approvals from regulatory agencies.
Attending, facilitating, and sometimes leading standing meetings with Client stakeholders, Clients CM and GC, and regulatory agencies to evaluate project statuses and ad-hoc meetings to resolve outstanding issues.
Attend and provide feedback during over-the-shoulder review meetings of draft permit applications.
Responding to submittals and RFIs via project management platform in a timely manner.
Identifying potential risks that would cause impacts to the Clients project schedule and working with Client Project Managers to develop solutions to eliminate or mitigate risk.
Responding to daily emails and calls from Client and contractors.
Interface with utility companies to deconflict competing projects.
Developing materials as needed for Client progress calls and/or meetings.
Maintaining a Permit and Easement Log to track compliance on all applicable permits and easements.
Accurately documenting all work performed on a daily basis in Clients and InterAgencys time tracking platforms.
Supporting accounting team in developing monthly invoices.
Other duties assigned by supervisor in support of permitting operations.
Candidate Qualifications:
Bachelors or masters degree in architecture.
5+ years of professional experience in architecture or another A/E/C field.
Experience pursuing permits for medium-to-large development and/or civil infrastructure projects in Washington, DC.
Proficient knowledge of DC Government permitting platforms (TOPS, SGS, ACA, ProjectDox).
Familiarity with civil engineering drawings is a plus.
We are looking for highly motivated individuals willing to take on responsibility and grow with our team. We encourage people who are detail-oriented, collaborative, and good with time management to contact us.
Employment Conditions:
Type: Full Time, exempt employment
Location: Hybrid - Will work on-site at client location 2-3 days per week.
Washington, D.C. / Bethesda, MD
Hours: regular business hours, 8:00 am to 5:00 PM (EST).
Must be eligible to work in the U.S. without Sponsorship
Physical Requirements:
Must be able to perform essential duties satisfactorily with reasonable accommodation.
Work is generally done sitting, talking, hearing, and typing. Visual acuity to use a keyboard, prepare and analyze data and figures; transcribing, viewing a computer terminal; extensive reading.
Compensation and Benefits:
Annual salary: $110,000-$130,000, commensurate with experience.
Health, vision, and dental insurance
401(k) Safe Harbor employer match project
Paid holiday leave: All Federal holidays
Paid Time Off: 20 days / year
Reimbursement for maintenance of relevant professional licenses and certifications
Flexible spending account program
Dependent care account program
Eligible for annual performance bonus and raise
Company provided equipment and software, as needed
InterAgency employment practices are in accordance with the laws that prohibit discrimination against qualified
individuals on the basis of race, religion, color, gender, age, national origin, physical or mental disability,
genetic information, veteran
s status, marital status, gender identity and expression, sexual orientation,
or any other status protected by applicable law.
InterAgency is an equal opportunity employer.
Permitting Operations Manager (Mid-level / Senior Architect)
Washington, DC jobs
Our Company: InterAgency Inc. is a minority-owned DC-based small business specializing in environmental planning and permitting. Since 2011, InterAgency has helped water, wastewater, and transportation agencies navigate the regulatory process for some of the largest infrastructure projects in the DC Metro region.
Description: InterAgency is seeking a versatile, experienced architectural professional to manage permitting operations on behalf of a major water and wastewater utility client. This hybrid, client-facing role combines elements of project management, stakeholder engagement, and permit management. The successful professional will act as a key liaison between the client, internal teams, and external regulatory agencies to ensure timely permit approvals and smooth coordination. Ideal candidates are architects ready to transition from a traditional architectural role into a consulting and project management role with improved work-life balance.
Responsibilities:
Submitting permit applications via online portals for Client projects to regulatory agencies (DDOT, DOB, DOEE, etc.).
Reviewing permit submission documents for compliance with all Federal and local regulatory requirements.
Tracking status of ongoing permits and providing Client and InterAgency project managers with regular updates regarding permit comments, responses, and issues.
Ensuring that permit applications remain current and active, and facilitating Client's payment of invoices in a timely manner.
Advising Client and contractors on best practices for pursuing permit applications and negotiating approvals from regulatory agencies.
Attending, facilitating, and sometimes leading standing meetings with Client stakeholders, Client's CM and GC, and regulatory agencies to evaluate project statuses and ad-hoc meetings to resolve outstanding issues.
Attend and provide feedback during over-the-shoulder review meetings of draft permit applications.
Responding to submittals and RFIs via project management platform in a timely manner.
Identifying potential risks that would cause impacts to the Client's project schedule and working with Client Project Managers to develop solutions to eliminate or mitigate risk.
Responding to daily emails and calls from Client and contractors.
Interface with utility companies to deconflict competing projects.
Developing materials as needed for Client progress calls and/or meetings.
Maintaining a Permit and Easement Log to track compliance on all applicable permits and easements.
Accurately documenting all work performed on a daily basis in Client's and InterAgency's time tracking platforms.
Supporting accounting team in developing monthly invoices.
Other duties assigned by supervisor in support of permitting operations.
Candidate Qualifications:
Bachelor's or master's degree in architecture.
5+ years of professional experience in architecture or another A/E/C field.
Experience pursuing permits for medium-to-large development and/or civil infrastructure projects in Washington, DC.
Proficient knowledge of DC Government permitting platforms (TOPS, SGS, ACA, ProjectDox).
Familiarity with civil engineering drawings is a plus.
We are looking for highly motivated individuals willing to take on responsibility and grow with our team. We encourage people who are detail-oriented, collaborative, and good with time management to contact us.
Employment Conditions:
Type: Full Time, exempt employment
Location: Hybrid - Will work on-site at client location 2-3 days per week.
Washington, D.C. / Bethesda, MD
Hours: regular business hours, 8:00 am to 5:00 PM (EST).
Must be eligible to work in the U.S. without Sponsorship
Physical Requirements:
Must be able to perform essential duties satisfactorily with reasonable accommodation.
Work is generally done sitting, talking, hearing, and typing. Visual acuity to use a keyboard, prepare and analyze data and figures; transcribing, viewing a computer terminal; extensive reading.
Compensation and Benefits:
Annual salary: $110,000-$130,000, commensurate with experience.
Health, vision, and dental insurance
401(k) Safe Harbor employer match project
Paid holiday leave: All Federal holidays
Paid Time Off: 20 days / year
Reimbursement for maintenance of relevant professional licenses and certifications
Flexible spending account program
Dependent care account program
Eligible for annual performance bonus and raise
Company provided equipment and software, as needed
InterAgency employment practices are in accordance with the laws that prohibit discrimination against qualified
individuals on the basis of race, religion, color, gender, age, national origin, physical or mental disability,
genetic information, veteran
'
s status, marital status, gender identity and expression, sexual orientation,
or any other status protected by applicable law.
InterAgency is an equal opportunity employer.
Associate Director, Quality Field Operations - Travel
Maryland Heights, MO jobs
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start **Caring. Connecting. Growing together.**
This Director level is accountable for achieving assigned targets for Medicare Advantage providers in their assigned Market(s). The Director is responsible for developing and deploying business plans at the market level with a solid focus on managing CMS Risk Adjustment, Clinical Quality, HEDIS and Stars initiatives and building relationships across Market(s) to develop and optimize business opportunities and brand strength. Serving as the local Market expert, work with central function leads to target local strategies that will result in optimal Market(s) effectiveness.
You'll enjoy the flexibility to work remotely* from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
**Primary Responsibilities:**
+ Ensure targets are met or exceeded for assigned Market(s)
+ Development and execution of clinical, RAF and quality strategy related HEDIS and Part D Stars Improvements in partnership with Medicare Market CEO, Executive Director, Data Support, and other Optum and UHC parties as appropriate
+ Regular reporting and updates to senior leadership, including Health Plan CEO, CMO, and market leads, this requires development of PowerPoint and Excel data packages
+ Leadership and support of achieving a minimum of 4 Star rating for assigned H contracts and for achieving 80% of our members in 4 Star or better plans
+ Solid focus on employee development and employee experience
+ Monitor Market level trends, risk and opportunities to continually evaluate ability to achieve established targets
+ Create provider targets for direct reports and assist in territory management penetration
+ Actively participate in the development and execution of site Coding Accuracy, HEDIS, (prospective and retrospective), Patient Experience and Stars strategic/business plans
+ Influence the development and improvement of operations/service processes
+ Drive the development and implementation of short-and-long range plans
+ Continually assess market competitiveness, opportunities, and risks
+ Drive initiatives to optimize Medicare Advantage payment and reimbursement strategy and capabilities
+ Build and maintain collaborative relationships with Corporate, Business units within UHG and other Medicare Advantage Plans, Provider relations/Network Development, Marketing and Sales, Clinical Operations, Senior Director leadership in each market
+ The Director will be accountable to ensure direct reports that oversee the field staff are performing at a high standard of performance
+ Be the primary go to person for all Risk/STARS related activities within their assigned market(s) working within a matrix relationship which includes Network, Market Leads, Health Plan Medical Directors, and other Health Plan and Optum team members to assure that all STARS activities are planned and executed
+ Weekly commitment of 50% travel for business meetings (including client/health plan partners and provider meetings) and 50% remote work
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
**Required Qualifications:**
+ 5+ years of experience in a high impact role as a leader in the managed health care industry
+ 5+ years of Medicare Stars experience and HEDIS experience
+ Experience in the development and execution of Coding Accuracy, HEDIS (prospective and retrospective), Patient Experience and Stars strategic/business plans
+ Experience developing and improving operations / service processes including short and long range plans
+ Demonstrated experience on driving initiatives to optimize Medicare Advantage payment and reimbursement strategy and capabilities
+ A broad base of experience across management care operations, extensive knowledge of health care industry, provider and insurance industry is required to be successful in this role
+ Weekly commitment of 50% travel for business meetings (including client/health plan partners and provider meetings) and 50% remote work
**Preferred Qualifications:**
+ Reside in the upper Midwest (Missouri / Nebraska / Iowa / Illinois )
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $110,200 to $188,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.
**Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
Associate Director, Quality Field Operations - Travel
Maryland Heights, MO jobs
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
This Director level is accountable for achieving assigned targets for Medicare Advantage providers in their assigned Market(s). The Director is responsible for developing and deploying business plans at the market level with a solid focus on managing CMS Risk Adjustment, Clinical Quality, HEDIS and Stars initiatives and building relationships across Market(s) to develop and optimize business opportunities and brand strength. Serving as the local Market expert, work with central function leads to target local strategies that will result in optimal Market(s) effectiveness.
You'll enjoy the flexibility to work remotely* from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
Primary Responsibilities:
* Ensure targets are met or exceeded for assigned Market(s)
* Development and execution of clinical, RAF and quality strategy related HEDIS and Part D Stars Improvements in partnership with Medicare Market CEO, Executive Director, Data Support, and other Optum and UHC parties as appropriate
* Regular reporting and updates to senior leadership, including Health Plan CEO, CMO, and market leads, this requires development of PowerPoint and Excel data packages
* Leadership and support of achieving a minimum of 4 Star rating for assigned H contracts and for achieving 80% of our members in 4 Star or better plans
* Solid focus on employee development and employee experience
* Monitor Market level trends, risk and opportunities to continually evaluate ability to achieve established targets
* Create provider targets for direct reports and assist in territory management penetration
* Actively participate in the development and execution of site Coding Accuracy, HEDIS, (prospective and retrospective), Patient Experience and Stars strategic/business plans
* Influence the development and improvement of operations/service processes
* Drive the development and implementation of short-and-long range plans
* Continually assess market competitiveness, opportunities, and risks
* Drive initiatives to optimize Medicare Advantage payment and reimbursement strategy and capabilities
* Build and maintain collaborative relationships with Corporate, Business units within UHG and other Medicare Advantage Plans, Provider relations/Network Development, Marketing and Sales, Clinical Operations, Senior Director leadership in each market
* The Director will be accountable to ensure direct reports that oversee the field staff are performing at a high standard of performance
* Be the primary go to person for all Risk/STARS related activities within their assigned market(s) working within a matrix relationship which includes Network, Market Leads, Health Plan Medical Directors, and other Health Plan and Optum team members to assure that all STARS activities are planned and executed
* Weekly commitment of 50% travel for business meetings (including client/health plan partners and provider meetings) and 50% remote work
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
* 5+ years of experience in a high impact role as a leader in the managed health care industry
* 5+ years of Medicare Stars experience and HEDIS experience
* Experience in the development and execution of Coding Accuracy, HEDIS (prospective and retrospective), Patient Experience and Stars strategic/business plans
* Experience developing and improving operations / service processes including short and long range plans
* Demonstrated experience on driving initiatives to optimize Medicare Advantage payment and reimbursement strategy and capabilities
* A broad base of experience across management care operations, extensive knowledge of health care industry, provider and insurance industry is required to be successful in this role
* Weekly commitment of 50% travel for business meetings (including client/health plan partners and provider meetings) and 50% remote work
Preferred Qualifications:
* Reside in the upper Midwest (Missouri / Nebraska / Iowa / Illinois )
* All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $110,200 to $188,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Vice President Plan Operations & Administration
Raleigh, NC jobs
The VP Plan Ops and Admin is responsible for leading the Plan Operations for the North Carolina Medicaid plans. This role will support the Market President in executing the enterprise strategic plan at the local level by driving market strategic initiatives that align to contractual requirement, priorities and stakeholder needs. This role serves as a second in command to the Market President, ensuring all components of the North Carolina plan infrastructure are operating effectively and efficiently and that all service levels are met by coordinating across shared service functional areas to ensure that the enterprise strategy is executed within the regulatory requirements of the Plans.
**Work Arrangement: ;** This position with hybrid with frequent travel within the state. ;Will attend state and provider meetings.;
**Essential Functions**
+ Apply deep knowledge of state program contractual and regulatory requirements (benefit and payment rules, data and information submission specifications, performance and service level requirements, etc.), to ensure Plan requirements are met. Coordinate with shared services when issues are identified to perform root cause analysis, develop solutions, and implement solutions in a timely and complete fashion.
+ Monitor performance against process improvement measures, serving as the liaison between the health plan and enterprise/shared service functions to drive adherence.;
+ Partner with Service Operations on Plan issues regarding significant service operations changes, specifically related to APD-DRG, ICD-10 and implementation of enterprise special projects/programs.
+ Lead cross functional Plan operational meetings to drive collaboration across Plan and shared services resources to ensure alignment and coordination of Plan activities and issue resolution.
+ Monitor results and develop action plans for operational and cost containment initiatives, in collaboration with the Plan Finance Director and Market CMO.
+ Develop and monitor the Plan specific risk profile and mitigation strategies and proactively identify risks that would impact the Plans ability to meet enterprise and local strategic and financial goals and in collaboration with Enterprise Risk Management, develop strategies to mitigate the risks.
+ Serve as the PA lead for the Delegation Oversight Committee of our parent company; coordinate across enterprise shared services to provide comprehensive updates in accordance with the Committee's monthly and quarterly meeting schedule.
+ Serve as day-to-day leader for the Provider Network Operations, Community Engagement & Outreach, Regulatory, and Data & Technical Services teams, with leadership responsibility for over 100 associates.
**Education/Experience:**
+ Bachelor's Degree required.;
+ Preferred Experience: previous experience in a health plan leadership role.
+ 5 or more years operational experience in Medicaid/Medicare.
+ 10 or more year progressive responsibility in Business, Government, or Health Care Management experience.
+ In-depth understanding of Medicaid/Medicare operations and benefit administration.
+ Proven experience in navigating relationships in a matrixed organization.
**Our Comprehensive Benefits Package**
Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.
Your career starts now. We're looking for the next generation of health care leaders.
At AmeriHealth Caritas, we're passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we'd like to hear from you.
Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.
Discover more about us at ************************** .
;
As a company, we support internal diversity through:
Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.
Operations Access Manager-Operations
North Carolina jobs
At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.
Duties and Responsibilities of this Level
Provide direction for the department in accordance with the vision, values and expectations of Duke Medicine Access Services.
Promote and model a patient-centric and customer service focus within the department as well as with external clients and customers.
Develop the department's operational policies, procedures standards and expectations, providing clear opportunities to meet or exceed the entity balanced scorecard objectives.
Maintain liaison with all levels of administration, physicians and outside organizations to coordinate business and accomplish directives. Ensure the department is integrated with other departmental areas within DMAS.
Provide oversight and direction for designated employees. Direct and coordinate various personnel functions including, but not limited to: hiring, performance appraisals, promotions, transfers and vacation schedules. Develop and mentor direct reports and staff.
Develop the department operating budget and goals. Oversee and monitor the financial, service and productivity performance of the department. Proactively monitor, analyze and manage reports and all related documents.
Perform other related duties incidental to the work described herein.
Required Qualifications at this Level Education
Bachelor's degree in business or related field is required.
Experience
Five years of experience in healthcare or other applicable experience directly related to the department is required.
Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status.
Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.
Essential Physical Job Functions:
Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.
Area Manager (Smart Metering)
Yorkshire, VA jobs
* Right across infrastructure, there's a requirement to not only maintain, but also renew and reimagine. Whatever stage you're at in your career, with us you'll have an opportunity to grow and develop. Delivering essential infrastructure services for life, while being safety first, and client and customer centric in a friendly, fun and respectful environment where you are encouraged to thrive.
Where will you be working?
We help our clients safeguard the water supply, improve environmental performance and manage demand for future generations. We enhance and extend asset life, ensuring compliance with water quality and environmental standards. We're problem solvers with over 140 years of combined experience in engineering and infrastructure.
This role will be within our Demand management and network infrastructure team. We look after 60 million meters and our teams provide advanced metering solutions to help manage demand for essential suppliers.
Want to be a part of it?
As a Team Manager, you will be part of our Operations Team working on the Smart Metering Contract who are responsible for the installation of Yorkshire Water's 1.4 million smart metering programme and is critical to the region's future supply needs.
You will be responsible for overseeing daily operations across multiple areas, ensuring compliance with SHEQ standards. You will coordinate teams; operatives, manage resources and maintain high productivity levels while fostering a positive and safety-conscious work culture.
What you'll bring
* Engagement with operational teams daily to ensure work progresses according to programme schedules.
* Produce, maintain, and brief SHEQ documentation in a timely and accurate manner.
* Coordinate resources, materials, and equipment to meet daily productivity targets.
* Support SHEQ initiatives including toolbox talks, quality assurance, and liaison with the clients
* Conduct regular van and onsite audits for all teams to ensure compliance and standards are met.
* Supervise teams to prevent Fixed Penalty Notices (FPNs) and Section 74 fines.
* Ensure all operatives are trained, competent, and have up-to-date qualifications.
* Deliver inductions and team meetings (stand-downs) to maintain communication and safety awareness.
* Support the management and planning teams with operational insights and updates.
* Maintain accurate productivity trackers and site performance statistics.
* Coordinate procurement activities with the supply chain to ensure timely delivery of materials and services.
* Promote a positive and respectful approach when dealing with customers and members of the public.
What you'll bring
* Proven management experience or similar supervisory role within utilities
* Excellent leadership, communication, and organisational skills.
* Full UK driving license
What's in it for you?
We offer a range of benefits designed to support your life in and out of work, some of which include;
* Matched or contributory pension scheme
* Online GP service, 24 hours a day, 365 days a year
* Employee assistance programme
* My Rewards portal, access to 1000's of retail discounts
* Life assurance
* Cycle to work, salary finance and give as you earn schemes
* Enhanced maternity, paternity leave and adoption leave
* Reward and recognition scheme
In addition, this role offers;
* Company car and fuel card with a range of EV and hybrid vehicles to choose from
* My Car Choice our salary sacrifice EV/ Hybrid car scheme
* Private Healthcare
* 21 days annual leave plus bank holidays
* Recommend a friend - get rewarded for introducing people to us!
About us
We want to be an employer of choice and a great place to work, attracting diverse and talented people, who join us and make a difference. We're one of the Top 100 UK companies actively supporting and recruiting army veterans. Our ENABLE inclusion networks bring together people who have a shared passion, to help create an environment where everyone belongs.
Our values help to shape our culture and how we work with one another. We recruit with these values in mind, to ensure your aspirations, and ways of working, align with ours.
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Manager, Sales Operations
Washington, DC jobs
In order to be considered for this role, after clicking "Apply Now" above and being redirected, you must fully complete the application process on the follow-up screen.
The Manager, Sales Operations will play an integral role in the day-to-day operation of the Ticket Sales and Service Department.
This position will report directly to the Senior Vice President, Ticket Sales & Service. The primary responsibility of this position will be to assist the sales and service staffs as well as the management team in increasing the efficiencies of the department, ultimately resulting in additional revenue and ticket sales for the organization.
The Nationals are a military-friendly organization actively recruiting veterans and spouses.
Essential Duties and Responsibilities:
Support Season Ticket (New & Retention) efforts and Group Sales initiatives
Manage multiple schedules and timelines related to campaign rollouts (Season Tickets, Renewals, Group Tickets, Special Ticket Events, etc.)
Assist with the implementation and execution of strategic sales and retention plans throughout campaigns (i.e. website creation, collateral production, giveaway fulfillment, etc.)
Event-planning and coordination related to Sales/Service initiatives (i.e. sales presentations, member events, reward incentives, etc.)
Content capture for future group event marketing efforts
Assist with creative and strategic planning for internal sales and service campaigns
Serve as liaison with Marketing/Creative/Social Media/Web Design departments in order to forward sales/service objectives
Facilitate external sales and marketing initiatives for new prospects and current clients
Assist with internal and external email marketing initiatives (i.e. schedule management, timing, copywriting, etc.)
Prepare all necessary submission requests needed to execute full marketing campaigns to further ticket sales initiatives (i.e. creative, social media, etc.), inclusive of in-park and in-broadcast activations
Interface with Business Strategy & Analytics department to streamline sales and retention efforts
Assist Director, CRM with lead distribution management through Salesforce CRM
Manage Ticket Sales & Service Interns, that will provide game day support as well as assist with Ticket Sales and Service events and administrative tasks
Serve as liaison with Finance and Purchasing departments to maximize efficiency and fiscal responsibility
Consistently deliver a high level of customer satisfaction across all sales and service platforms
Engage with all members of the sales and service leadership team in order to achieve departmental goals
Game duties as assigned
Requirements:
Minimum Education and Experience Requirements
Bachelor's Degree or equivalent military experience.
Minimum of 3 years of experience. Professional or collegiate team experience preferred.
Experience within Ticket Sales, Ticket Service and/or Marketing.
Knowledge, Skills, and Abilities necessary to perform essential functions
Candidate must be highly proficient in Microsoft Excel and Adobe Photoshop and InDesign
Required to address and solve problems quickly and effectively
Outstanding organizational skills and ability to manage & prioritize multiple tasks
Able to work nights, holidays, and weekends, including Nationals home games
Uphold Core Values: Integrity, Teamwork and Innovation. These core values set the tone in everything we do, help us succeed on and off the field, make a difference in the community and provide the best guest experience in sports. It is important that the person in the position commits themselves to these core values so that we can constantly move forward in the same direction - Together
Physical/Environmental Requirements
Office: Working conditions are normal for an office environment. Work may require occasional weekend and/or evening work.
Compensation:
The projected wage rate for this position is $24.03 - $28.80 per hour. Actual pay is based on several factors, including but not limited to the applicant's: qualifications, skills, expertise, education/training, certifications, and other organization requirements. Starting rates for new employees are frequently not at the top of the applicable hourly range.
Benefits:
The Nationals offer a competitive and comprehensive benefits package that presently includes:
Paid vacation and sick leave, paid holidays throughout the year and a holiday break in December
Medical, dental, vision, life and AD&D insurance
Short- and long-term disability insurance
Flexible spending accounts
401(k) and pension plan
Access to complimentary tickets to Nationals home games
Employee discounts
Free onsite fitness center
Equal Opportunity Employer:
The Nationals are dedicated to offering equal employment and advancement opportunities to all individuals regardless of their race, color, religion, national origin, sex, age, marital status, personal appearance, sexual orientation, gender identity or expression, family responsibilities, matriculation, political affiliation, genetic information, disability, or any other protected characteristic under applicable law.
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.