Claims Manager
American Family Insurance GroupSalary not specified
- Full Time
- Junior (1 to 2 years)
Not SpecifiedCompensation
Mid-level (3 to 4 years), Senior (5 to 8 years)Experience Level
Full TimeJob Type
UnknownVisa
Healthcare, InsuranceIndustries
Requirements
Candidates should possess a Bachelor’s degree, with an advanced degree preferred, and a minimum of 7 years of experience at a third-party administrator or regional/national health plan, along with 5 years of experience in an operations role of significant scope and 5 years of proven leadership experience managing teams. They should also demonstrate deep knowledge of self-funded health plans and compliance in the healthcare payer space.
Responsibilities
The VP, Claims Operations will provide coaching and mentorship to department leads, partner with Finance and executive leadership to manage budgets and align operational investments, collaborate with internal stakeholders, participate in enterprise-level strategy sessions, and provide departmental leadership and operational oversight. This role will also involve developing and implementing operational strategies, policies, and procedures, leading operational improvement initiatives, ensuring timely and accurate claims adjudication, overseeing audits and corrective action plans, and fostering a culture of accountability and execution rigor within assigned departments.
Skills
Claims Adjudication
Self-Funded Health Plans
Compliance
Healthcare Payer
Operational Strategy
Budget Management
Leadership
Team Management
Audit Management
Policy Development
Centivo
Affordable health insurance with primary care focus
About Centivo
Centivo provides health insurance focused on making healthcare affordable and accessible. The company emphasizes primary care, offering free primary care services, no deductibles, and low, predictable copays to help keep its members healthier and reduce the need for hospital visits. Centivo generates revenue by charging employers for health plans provided to their employees, which leads to lower medical costs and increased usage of the plans. A key feature of Centivo's offering is its integrated virtual care service, allowing members to access care conveniently. The company is distinguished by its commitment to quality, curating providers based on strict price and quality standards, particularly in primary care. Centivo's goal is to enhance the member experience while lowering overall healthcare costs.
Key Metrics
Buffalo, New YorkHeadquarters
2017Year Founded
$183.7MTotal Funding
DEBTCompany Stage
Financial Services, HealthcareIndustries
201-500Employees