Job Description

Job Title: Supervisor, Insurance Claims- CHC
Job ID: 29573693
Status: Full-Time
Regular/Temporary: Management
Hours:
Shift: Day Job
Facility: UPMC Health Plan
Department: CHC Claims Operation
Location: 600 Grant St, Pittsburgh PA 15219

Description

Purpose:
This position is responsible for the supervision of day to day operations for TPA Ops Services. This includes monitoring staff production and quality, identifying training needs, creating staff development programs, monitoring and maintaining acceptable inventory levels, providing support to TPA staff and team leaders; as well as measuring outcomes of employee development, efficient inventory management, individual and team performance against regulatory, compliance, and client service level agreements.

Responsibilities:
  • Collaborate and create employee development programs that support job and career growth; align employee performance with department goals and objectives
  • Ensure team members understand Client Service Level Agreements (SLAs), Performance Guarantees, Regulatory and Compliance expectations; and align individual and team output accordingly; consistently communicate daily team goals and progress
  • Effectively balance resources across multiple clients and team inventories to meet or exceed claim timeliness and quality goals
  • Serve as a mentor to less experienced supervisory staffManage special projectsPerforms other duties as assigned
  • Meet deadlines and turnaround times set by management (these deadlines and turnaround times will, at times, require the employee to work until the project is completed, meaning extended daily work hours, extended work weeks, or both)
  • Strategize, plan, organize, and execute efficient inventory management
  • Supervise and monitor ongoing performance of team members. Continually examine team performance against department standards. This includes employee recognition as well as timely, constructive, and helpful feedback
  • Effectively monitor and track client and internal complaints/errors for training and process improvement opportunities
  • Ensure team promptly and thoroughly responds to sensitive/high profile internal and client issues/complaints
  • Serve as a role model in ?Strive for Excellence? by supporting a positive work atmosphere, promoting quality outcomes that focus on a positive staff experience, providing quality support services that are responsive to customers? needs, proactive in scope, and accessible in nature
  • Participate in interviewing, hiring, and training of team members; Enhance communication via effective team meetings, huddles, and employee one on ones;Partner with Internal Departments, Providers, Clients, and Management to make recommendation and improve operational performance;

Qualifications

  • Bachelor's degree in management, organizational leadership, health care, or other related field or equivalent work experience;
  • Self-directed with a minimum of six years health insurance experience, with at least one year supervising an operation team; along with two years facilitating/coordinating the completion of tasks or projects via others;
  • 3 years customer/client service experience strongly preferred;Experience in training, developing, and coaching staff;
  • Excellent organizational, interpersonal, and written communication skills a must;Strong leadership skills and abilities; strong independent decision-making ability a must.
  • Thorough knowledge of Commercial, Medicare and Medical Assistance programs required.
  • Must be able to simultaneously manage more than four varying operation production inventories; while assisting in resolution of high profile client issues; Must be able to thrive in a fast-paced production environment; 
  • Project and process management skills strongly preferred;Competence in MS Office and PC skills required.

Licensure, Certifications, and Clearances:

UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities

Salary Range: $0 / hour

Union Position: No

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