AVP Claims

Job Summary

Here at LIBERTY our FLOSSify is simple, find good people and help them shine.

LIBERTY's Claims department is seeking an Assistant Vice President to oversee our Claims department nationwide. Prior experience working with Claims in a dental environment highly preferred. 

This position is responsible for directing the National Claims Operations, ensuring that quality and compliance standards are being met and the best possible service is being provided to our customers. Provides strategic leadership to National Claims Operations including long-term planning, technology strategy, and continuous improvement of operational efficiency.

• Responsible for the development and execution of Claim Operations strategies, E2E Claim process automation, optimization and management, identifying and leveraging technology and data to improve the quality and minimize process cost of Claims for all LIBERTY plans.
• Closely align with Benefit Implementation and Utilization Management leadership to identify new strategic initiatives to include verifying value-adds and risks.
• Ability to successfully manage change and growth as well as juggle multiple and changing priorities with sometimes conflicting deadlines.
• Develop cost containment strategies to support the fiscal needs of the company.
• Confer with leadership to discuss goals and objectives, to review progress, and to determine the needs to support corporate strategy.
• Prepare operation, productivity, and forecasting reports for management analysis.
• Ensure we appropriately respond to correspondence regarding complaints, audits and inquiries that require management attention.
• Keep current on state and federal regulatory issues and industry activity and trends.
• Assist with various projects and initiatives.
• Complete all necessary tasks associated with managing direct reports in a timely fashion (e.g. time cards, performance reviews, holding timely one-on-one meetings, etc.).

Education/Experience:

• Minimum 4-Year Bachelor's degree required or 5 years' experience directing/managing a Healthcare or Dental Plan Claims Department.
• Minimum 10 years' experience in a managerial capacity with a minimum of 7 years in a healthcare or dental plan operations role.
• Prior Claims experience in a dental environment highly preferred.
• Prior experience with claims regulatory requirements (DMHC, CMS, DOI, ERISA, NCCI, HIPAA regulations)

Skills/Knowledge:

• Knowledgeable of claims regulatory/compliance requirements
• Broad knowledge of technology
• Strong leadership ability
• Analytical skills with emphasis on generation and utilization of data to drive operational and financial performance
• Ability to manage multiple projects and heavy workload
• Strong communication skills

Sponsorship and Relocation Specifications:

LIBERTY Dental Plan is an Equal Opportunity Employer / VETS / Disabled.

No relocation assistance or sponsorship available at this time.