Delaware First Health · 2 hours ago
Senior Manager, Claims
Newark, DE
Full-time
Onsite
Mid, Senior Level
$108K/yr - $199K/yr
5+ years expDelaware First Health is transforming the health of communities, and they are seeking a Senior Manager for Claims. The role involves managing claim processing units, overseeing multiple states and lines of business, and driving process improvements while leading a team.
Health CarePersonal HealthWellness
No H1B
Responsibilities
Directly and indirectly manages the activities of managers, supervisors and subordinate work group(s) for regional claim processing units
Oversees multiple states and lines of business, considers issues and impacts at a departmental level, and has ongoing collaboration with key business partners to identify and resolve process issues
Drives solutions, function in a leadership capacity in addressing issues, and focuses on departmental needs that go beyond those of their individual teams
Responsible for the performance management processes for direct reports including coaching, counseling, providing feedback, career planning, goal setting, and performance assessment
Recruits, selects, trains and retains highly qualified professionals
Mentors lower level management for succession planning
Investigates, recommends alternatives and provides guidance for claims-related process improvement initiatives, seeking root cause and developing appropriate corrective action with the objective of meeting production, timeliness and quality standards at a departmental level
Evaluates alternatives, resolves issues, proposes and implements solutions with minimal supervision
Plans, conducts and directs work on projects/programs necessitating the origination and application of new approaches
Makes recommendations for improvements to business processes and participates in discussions with senior management to plan and create business improvements at a departmental level. Developing appropriate corrective actions
Leads the implementation of programs and strategies and plays a major role in working with other business units to coordinate workflow and improve results
Develops collaborative relationships and addresses problems with sense of diplomacy in order to preserve them
Provides recommendations on matters of policy in areas of expertise
Presents issues and solutions, conferring with director as needed, and leads to resolution
Steps into role of director when director is absent and ensures that no disruption to day to day business and / or strategic activities occurs
Performs other duties as assigned
Complies with all policies and standards
Qualification
Required
Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future
Bachelor's Degree in a related field or equivalent experience required
5+ years experience in operations, claims or financial management preferably in a managed care setting
3+ years in a supervisory capacity including hiring, training, assigning work and managing performance required
Benefits
Health insurance
401K
Stock purchase plans
Tuition reimbursement
Paid time off plus holidays
A flexible approach to work with remote, hybrid, field or office work schedules
Company
Delaware First Health
Delaware First Health offers Medicaid-managed care plans, improving individual and community health and wellness.
0-1 employees
Funding
Current Stage
Early StageLeadership Team
Bill Wilson
Plan President and CEO
Tiffany (Aany) Tazmin-Ewing, FSA, MAAA
Chief Financial Officer
Recent News
Company data provided by crunchbase