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Smith+Nephew · 21 hours ago

Senior Manager, Commercial Insurance Verification Operations

Andover, MA

Full-time

Hybrid

Senior Level

$111K/yr - $167K/yr

7+ years exp

Smith+Nephew is a company that designs and manufactures technology to improve lives. The Senior Manager of Commercial Insurance Verification Operations will lead a team responsible for insurance verification and prior authorization submissions, while optimizing operations and ensuring compliance with policies.

Medical Device

Comp. & Benefits

Responsibilities

Lead a high-performing team responsible for executing insurance verification and prior authorization submissions for commercial customers

Optimize operations and communications with both customers and internal sales teams

Oversee a team of 50 individuals across various levels, providing coaching, guidance, and clear communication to foster an engaged, high-performing culture

Manage operations, support supervisors, and ensure consistent delivery of training, development, performance feedback, and communication

Maintain staffing plans aligned with production needs, monitor departmental KPIs, and address escalated payer issues or complex verification cases, including direct communication with insurance carriers

Monitor and manage departmental budgets and contribute to budget setting and forecasting

Continuously improve processes and technologies to enhance operational efficiency

Ensure strict adherence to compliance and privacy policies, identify risks, implement mitigation strategies, and establish governance frameworks and internal controls

Drive continuous process improvement by developing and implementing plans that enhance efficiency and customer experience

Collaborate with IT and stay informed of payer-specific policies and costing guidelines relevant to medical devices and DME billing

Work closely with teams across Sales, Reimbursement, and Market Access to deliver optimal customer outcomes

Qualification

Budget managementOperational excellenceInsurance verificationProcess improvementLeadership in matrixed environmentsData analysisVendor relationship managementCross-functional collaborationCommunication skills