Senior Director of Claims Administration Job in Denver, Colorado US
Senior Director of Claims Administration
At Kaiser Permanente, the way we deliver health care is different. We are the caregiver, the hospital, the laboratory, and the pharmacy. In fact, what makes us unique is that we play every position across the care continuumâ?"providing the health care coverage and delivering the health care itself. Because of this, our organization is driven by professionals whose roles range from health care and business professionals to construction and customer service experts. What brings us together is our universal commitment to improve the health and wellness of our members, patients, colleagues, and communities. We are searching for an Senior Director of Claims Administration to join the Colorado Region of Kaiser Permanente. Senior Director of Claims Administration - Colorado Region Provides leadership, business acumen management of the Claims Administration function, including Business Configuration Claims Administration operations for KPCO Health Plan Service Administration (HPSA). The position also has overall accountability for the business process outsourcing agreement w/ the HI region for administration of their claims configuration business. Position will be accountable for business leadership of End-to-End Claims Administration process for the CO HI regions Essential Functions: - Responsible for end to end claims administration, including planning, recommending implementing major process improvement initiatives. - Demonstrates a highly collaborative approach to addressing a wide variety of claims administration requirements. Provides workable solutions to senior management oversees the successful implementation of initiatives - Establishes effective relationships w/ key customers to include national regional executives, directors, managers functional leaders: External: members, employer groups, brokers consultants, regulatory agencies external vendors - Internal regional departments: Member Services, Network development/provider contracting, Membership Benefit Administration, IT, Revenue Cycle - HI regional stakeholders - Implements monitors processes that continually improve the consistency reliability of the service provided to members, employers, brokers providers - Meets all compliance SOX requirements - Participates in cross regional national claims community of practice - Plans, oversees monitors department budgets responsibly - Achieve benefit realization of claims system technology investments - Operations Improvement/Performance Management Analytics to the Claims Admin team for program or project management of key initiatives, process management improvement, performance management business decision making, analysis, documentation - Develops strategic plans multi-function organizational policies authorizes their implementation for areas of responsibility - Lends support, leadership and/or sponsorship to cross-regional or cross-department projects to increase organizational efficiency - Partners cross regionally to leverage best practices execute on program-wide strategies through communities of practice other channels - Accountable for meeting key performance metrics, identifying variances, root cause, implementing action plans for achieving targets. - In addition to defined technical requirements, accountable for consistently demonstrating service behaviors principles defined by the KP Service Quality Credo, the KP Mission as well as specific departmental/organizational initiatives - Also accountable for consistently demonstrating the knowledge, skills, abilities, behaviors necessary to provide superior culturally sensitive service to each other, to our members, to purchasers, contracted providers vendors