Health Plan Operations SupervisorVirtualVocations • Rockford, Illinois, United States
Health Plan Operations Supervisor
VirtualVocations • Rockford, Illinois, United States
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A company is looking for a Health Plan Claims Lead.
Key Responsibilities
Support operational aspects of service area and product expansions
Inspect and review claims processing quality, providing feedback to TPA
Manage TPA operations to ensure quality service delivery and compliance
Required Qualifications
Bachelor's degree or 6+ years of relevant healthcare operation experience
Four years of experience managing healthcare operation teams
Strong knowledge of ACA / IFP and commercial claim requirements
Experience in oversight management of TPA operations for claims
Background in developing and reviewing operational SOPs and business requirement documents
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