United Concordia Companies Inc
Job Description :
Provide tactical and strategic direction for the operational activities of United Concordia Dental’s (UCD) Government Business Operations (GBO) division, which is comprised of Claims, Customer Service, Enrollment and Billing, and Dental Case Management operations. Create a work environment that motivates and rewards employees to recognize individual and group achievement, consistently meet service performance standards, and to continuously enhance the quality, compliance and effectiveness of operational processes. Aid in the response to government RFP’s, by providing strategic input for the technical (operational) volumes of UCD’s proposals.
Employee Referral Payout: Level 2
1.Lead a broad team of customer service, claims, enrollment and billing, case management and supporting personnel to meet or exceed all contractual and corporate operational objectives established for all government business contracts owned by United Concordia.
2.Facilitate planning sessions with business and IT leaders to identify, develop and write a unique technical (operational) win strategy and proposal for all major government business RFPs that United Concordia strategically selects to pursue.
3.Create an engaging work environment that inspires innovation, motivates a consumer centric focus and provides meaningful reward and recognition for both individual and group achievement towards both contractual and corporate objectives.
4.Analyze leading operational indicators, identify opportunities for process improvements and champion initiatives that achieve the opportunity of lower costs, improved member experiences and shorter cycle times.
5.Engage government program leaders and contract administration owners, as appropriate, in order to ensure that immediate and future service delivery expectations are, and continue to be, met for all government contracts.
6.Ensure the GBO division’s adherence to United Concordia’s current strategic delivery framework and corporate vision, goals and objectives.
7.Other duties as assigned or requested.
- A Bachelor’s Degree in Business Administration, Management, Health Policy or a related field.
- 7+ years of management experience in a health/dental insurance operations environment.
- Due to Department of Defense (DoD) contract requirements, the incumbent who fills this position must be a US citizen, and must also pass a background check.
- Proven leadership, motivation, planning, project management, and organizational skills.
- Successful attainment of a Department of Defense DIACAP security clearance.
- Master’s Degree in a related field.
- Experience with the confidentiality requirements of the Health Insurance Portability and Accountability Act (HIPAA) and the Privacy Act.
- Familiarity with dental terminology and procedure codes.
- Understanding of COB, Ortho, x-ray, grievance and predetermination workflows and processes.
- Military experience or an understanding of military culture, ranks, practice and protocols.
Knowledge, Skills and Abilities
- Extensive knowledge of Insurance operations
- Thorough knowledge of Insurance systems and applications (such as Inquiry, Claims, Membership, Telephony systems)
- Ability to apply analytical frameworks to unstructured business problems
- Ability to lead without formal authority
- Strong verbal and written skills
- Knowledge of healthcare industry trends and challenges
- Experience in operational improvement
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