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    Director, Medical Claim Audits - New York, United States - WTW inc.

    WTW inc.
    WTW inc. New York, United States

    3 weeks ago

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    Description

    The Regional Claim Audit Lead for Health & Benefits (H&B) Compliance & Audit will work closely with the H&B Claim Audit Leader. The role will be a combined individual contributor and leadership role. As an individual contributor, the Regional Claim Audit Lead is responsible for driving targeted new national business growth and managing the overall success of audit delivery across the East. The Audit Lead will collaborate with other Regional Leads to build and execute a national market sales strategy to meet annual growth targets. The Claim Audit Lead will review market needs to understand and recommend opportunities for growth; and define, prioritize, implement pursuit strategies accordingly and manage/oversee audit projects while acting as the liaison between clients and their vendor partners. The role is targeted to focus 40% of the leader's time on sales pursuits and driving local market sales execution. 40% of time will be devoted to an Audit book of business and audit project management and delivery. The remaining 20% of time will be allocated to People Manager responsibilities.

    The role will report directly into the H&B North America Audit Leader.

    The Role

    • Serve as member of the Audit leadership team charged with building and executing sales strategy to acquire new clients, retain/expand current clients, and meet/exceed our annual growth plan
    • Partner with local MLs and RSL to implement intentional, targeted, and measurable go-to-market strategies tied to national sales plan
    • Review and use data to help identify the top new business sales opportunities and partner with MLs and individual sellers to build pursuit plan for each
    • Manage and support the audit team, including goal setting and year end performance reviews, colleague issue support, training, development
    • Serve as people manager
    • Manage audit team staffing and delivery needs, creating community within the team
    • Effectively communicate with clients to deliver audit findings, identifying opportunities for improvement and collaborating with clients and their vendor partners to ensure long-term claim and benefits administrative improvement
    • Adept at collaboration and problem-solving in support of both the C&A community and the region
    • Escalate to the H&B North America Audit Leader any identified issues and barriers to sales
    • Identify opportunities for improved penetration of products/communities among clients and prospects
    • Contribute to the innovation and commercialization of audit work and future offerings
    • Support and engage C&A colleagues in pursuit of sales and ensure consistent processes and deliverables
    • Partner with producers and senior sellers on prospecting efforts, engaging other C&A colleagues as appropriate
    The Requirements
    • Experience leading high-profile new business sales pursuits and establish ongoing client relationships
    • Strong sales and presentation skills and commercial orientation with the ability to build and manage effective teams, work collaboratively across market segments, and influence colleagues at all levels of the company
    • Knowledge of the local market, H&B NA capabilities, and broader WTW offerings
    • Results-oriented with ability to effectively manage to KPIs
    • Comfortable with change and uncertainty and able to work through ambiguity
    • Excellent leadership, interpersonal and verbal and written communication skills
    • Strong business acumen, strategic planning, organizational, and creative thinking skills
    • Prior medical claim processing and/or auditing experience (dental claim processing/auditing knowledge optional)
    • Strong project management skills and ability to effectively manage multiple projects with competing deadlines
    This position will remain posted for a minimum of three business days from the date posted or until a sufficient/appropriate candidate slate has been identified.

    Base salary range and benefits information for this position are being included in accordance with requirements of various state/local pay transparency legislation. Please note that salaries may vary for different individuals in the same role based on several factors, including but not limited to location of the role, individual competencies, education/professional certifications, qualifications/experience, performance in the role and potential for revenue generation (Producer roles only).

    Compensation

    The base salary compensation range being offered for this role is $190,000 - $200,000 USD.

    This role is also eligible for an annual short-term incentive bonus.

    Company Benefits

    WTW provides a competitive benefit package which includes the following (eligibility requirements apply):
    • Health and Welfare Benefits: Medical (including prescription coverage), Dental, Vision, Health Savings Account, Commuter Account, Health Care and Dependent Care Flexible Spending Accounts, Group Accident, Group Critical Illness, Life Insurance, AD&D, Group Legal, Identify Theft Protection, Wellbeing Program and Work/Life Resources (including Employee Assistance Program)
    • Leave Benefits: Paid Holidays, Annual Paid Time Off (includes paid state/local paid leave where required), Short-Term Disability, Long-Term Disability, Other Leaves (e.g., Bereavement, FMLA, ADA, Jury Duty, Military Leave, and Parental and Adoption Leave), Paid Time Off ( Washington State only )
    • Retirement Benefits: Contributory Pension Plan and Savings Plan (401k). All Level 38 and more senior roles may also be eligible for non-qualified Deferred Compensation and Deferred Savings Plans.
    At WTW, we trust you to know your work and the people, tools and environment you need to be successful. The majority of our colleagues work in a "hybrid" style, with a mix of remote, in-person and in-office interactions dependent on the needs of the team, role and clients. Our flexibility is rooted in trust and "hybrid" is not a one-size-fits-all solution.

    We understand flexibility is key to supporting an inclusive and diverse workforce and so we encourage requests for all types of flexible working as well as location-based arrangements. Please speak to your recruiter to discuss more.

    EOE, including disability/vets
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