remote type
Hybrid – People Leader
locations
Phoenix
time type
Full time
posted on
Posted 30 Days Ago
job requisition id
R5186
Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.
This is a hybrid position that requires work and residency within the state of Arizona.
Purpose of the job
Provide supervision over the enrollment and billing functions for all lines of business including Commercial Group, Individual, Medicare and Federal Employee Program (FEP). The role includes complete ownership of process management including both internal and external functions that support enrollment, all payment related services, development of short- and long-term payment operations strategies and tactical plans, problem resolutions, and full functional alignment. This individual must coordinate across team efforts and manage internal and external relationships. The role also participates in the development of strategic plans to increase productivity.
REQUIRED QUALIFICATIONS
Required Work Experience
10+ years in healthcare industry working in payor segment with experience in operations, finance or general management fields
Required Education
High school diploma in general studies
Required Licenses
N/A
Required Certifications
N/A
PREFERRED QUALIFICATIONS
Preferred Work Experience
15+ years in healthcare industry working in payor segment with experience in ops, finance or general management fields
Preferred Education
Bachelor’s degree in a business, healthcare, or related field
Preferred Licenses
N/A
Preferred Certifications
N/A
ESSENTIAL job functions AND RESPONSIBILITIES
Motivate, manage, and lead high-performance teams involved in preparing, processing, and sustaining enrollment, including the correct filing of new member and group data
Manages payment processing function and supporting department metrics
Provide support and service quality to managers & team leaders when needed, including coaching and feedback reviews
Collaborate closely with operation leaders to resolve any escalation or conflict, acting as a single point of contact and subject matter expert for enrollment and billing operation issues with all lines of business
Collaborates closely with operation and finance leaders to resolve any escalation or conflict
Ensure all relevant quality standards, operational & fraud risk, operational & safety policies, and procedures & control across the organization in alignment with the strategic objectives to guarantee legislative compliance relative only to enrollment and billing functions
Address audit feedback and proactively identify risks and gaps
Ensure reporting exists, including timely, accurate and complete reports on all internal and external enrollment and billing processes
Oversee the development, training, and communication for onboarding of new staff
Control the continuous improvement roadmap for enrollment and billing including identifying projects to improve efficiency and effectiveness, e.g., automation pathways
Manages vendor relationships to ensure bills are processed and sent out in a timely manner to members to ensure an optimal member experience, acting as the ultimate business owner of the vendor relationship with procurement serving as a partner
STRATEGIC
Develop and align strategic plans to the corporate strategic pillars for growth, net income, and customer experience
With internal constituents, strategically plan the mission and vision for each account, with focus on large groups, to ensure flawless implementation and renewal activities for all operational activities
Translate emerging client needs into actionable business terms and associated process enhancements
Provide leadership and mentorship to team members on strategy, external research, best-practice analysis, business analysis, and implementation of client-centric business solutions
Coordinate and assist in development of enhancements to existing systems or creations of new systems to improve efficiencies to enrollment and billing, including capacity modeling, workforce management, service, cost, and quality impact
OVERALL
Oversee day-to-day departmental administration by coaching and motivating managerial staff and departmental personnel to make maximum use of experience and skills
Monitor quality performance measures, develop and maintain effective workflows, and seek to maximize system efficiencies
Manage use of corporate funds including budgeting, financial management, and reporting and identify opportunities to achieve administrative efficiencies while maintaining service levels
Maintain effective working relationships to ensure teamwork in achieving corporate goals
Coordinate activities between multiple divisions to achieve desired results
Participate in strategic planning activities and contribute to departmental and cross-functional teams to achieve BCBSAZ goals and ensure future success
Responsible for monitoring and meeting group performance guarantees
Support BCBSAZ’s Core Value of maintaining a heritage of service, by volunteering with, serving on, and/or supporting multiple Boards of Directors within the community or other community events
The position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements
Perform all other duties as assigned
REQUIRED COMPETENCIES
Required Job Skills
Deep understanding of operational, technical, and internal business processes
Proven ability to manage individuals and diverse teams in an enrollment and billing environment
Proficiency in business process design and bridging these to operational and technical solutions
Resource and project management skills
Ability to create win/win situations
Interpersonal and oral communication skills, including presentation skills
Strong written and verbal communications
Intermediate knowledge of electronic data processing systems, technology, and applications
Intermediate PC proficiency
Intermediate skill in use of office equipment, including copiers, fax machines, scanner and telephones
Intermediate skill in word processing, spreadsheet and database software
Intermediate skill using departmental BCBSAZ and BCBSA software
Required Professional Competencies
Demonstrated ability to engage with clients or external partners in a vendor/client relationship capacity
Demonstrated ability to build implementation plans and manage cross functional teams to achieve them
Strong familiarity with internal operational architecture and business processes
Solid creative judgment and ability to think strategically.
Advanced analytical and diagnostic skills dealing with issues that are often novel and not readily defined, lack known precedent or appear contradictory
Possesses expertise in the use of formal and informal communications and has the ability to give presentations that effectively communicate goals, ideas and concepts in alignment with audience needs, including frontline employees, managers, peer leaders and executive leadership
Management skills in an operationally changing environment, with drive for results and success based on planned objectives
Expert knowledge of the principles and practices of healthcare prepayment
Expert customer service skills
Interpersonal skills that allow for harmonious relationships with providers, members and coworkers
Interpersonal skills that allow for harmonious relationships with Group Benefit Administrator, Brokers, members and coworkers
Recognize strategic opportunities and use data to make timely and sound decisions
Flexibility and willingness to adjust to shifting demands/priorities
Ability and experience to assimilate multiple new functions, services, projects and systems while maintaining existing systems and programs
Ability to optimize resources to ensure cost effective operations. This includes proactively planning to move staff from one role to another as staffing needs change
Required Leadership Experience and Competencies
Ability to lead others in the same or higher levels to a valuable solution that may be novel or have no known set precedence in the client experience or operational areas
Decision analysis skills (ability to separate a complex whole into component parts)
Ability to empower associates at all levels and encourages innovation and risk taking.
Ability to effectively cope with multiple priorities, high customer expectations and bridge the demands between internal and external customers.
Resource management skills with the ability to develop an enthusiastic and positive work climate.
High standard of performance while pursuing aggressive goals
Principled leadership and sound business ethics
PREFERRED COMPETENCIES
Preferred Job Skills
Advanced PC proficiency
Advanced proficiency in spreadsheet, database, presentation, and word processing software
Preferred Professional Competencies
N/A
Preferred Leadership Experience and Competencies
N/A
Our Commitment
AZ Blue does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.
Thank you for your interest in Blue Cross Blue Shield of Arizona. For more information on our company, see azblue.com. If interested in this position, please apply. Click Here : Apply Now