Senior Manager, Operations - California
1 month ago

Job summary
The Senior Manager Operations Applications and Analytics has responsibility for providing leadership and management in the areas of claims related services including processing auditing research and resolution reporting and process improvement This position will be responsible for the coordination of Gold Coast Health Plans GCHPs outsourced claims processing transaction functions as well as the overall daily management of GCHPs internal Claims and Analytics team The internal Claims and Analytics teams primary focus is on claims operational analysis research projects auditing high dollar claims approval partnering with the G A department with provider disputes and supporting all other GCHP departments while transaction processing adjustments is performed by GCHPs vendor The Sr Manager of Operations Claims will ensure that the claims payment process adheres to regulatory requirements that payments are made according to benefit contract terms ,andthat providers have a high level of satisfaction with claims payment performanceThe candidate will have responsibility for providing leadership fity Management across a broad setof Operational Services Including Transaction Oversight Auditing Research Reporting And Process Improvement This Position Is Responsible For The Coordination Of Gold Coast Health Plan S Outsourced Operational Transaction Functions As Well As The Overall Daily Management Of Internal Operations And Analyticsteams
Job description
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