Director, Claims Performance & Analysis

Location: Town and Country, MO
Position Purpose: Oversee the execution of all claims automation, training, budget and planning initiatives. Manage the progress and performance of large scale projects that drive operational efficiencies and corresponding cost savings through automation initiatives. 
 
  • Participate in the development of business and project implementation strategies including identification and engagement of key resources to support projects
  • Manage cross functional activities related to large scale projects to deliver on schedule, within budget and with high level of quality
  • Act as single point of contact for all program related issues and escalations including risk management, technology strategy development and risk response strategy throughout the project
  • Communicate business objectives as well as technical complexities of the program to key stakeholders at many levels of the organization
  • Track, report and communicate program progress to team members and stakeholders; manage program repository and ensure all program documentation is up to date and accessible
  • Monitor the creation of all project deliverables to ensure adherence to quality standards including design documents, test plans, training materials, and operations documentation
  • Provide leadership and oversight in the development of integrated project work plans, schedules and budgets
  • Identify, assess and resolve process or system issues across functional areas

Qualifications:
Education/Experience:
  • Bachelor's degree in a Business or related field. Master’s degree preferred.
  • 7+ years of operations experience, preferably in a healthcare environment.
  • Previous operations experience in claims, provider/member services, medical management, or network/IT.
  • Experience leading a cross functional teams in implementation of a new, start-up business, business function or integration of an acquired business, preferably in the healthcare industry.
  • Exposure to project management, including use and understanding of project management methodologies and tools (i.e., integrated schedules, work breakdown structures, risk management, executive/scorecard reporting, project budgeting, project staffing, issue management and change control).
April A. Estes
Senior Recruiter
720-439-2609 Direct
april@proenlist.com 
www.proenlist.com 
www.medenlist.com 

www.linkedin.com/in/aprilaestes
 
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