Manager Service Operations

The Manager of Service Operations leads Enrollment & Billing Services operations and develops strategic plans and procedures in support of operational effectiveness, customer service goals and objectives. This individual will lead Enrollment & Billing Services teams supporting Individual and Medicare Advantage/Government Programs. They will implement initiatives to increase provider and member satisfaction. Oversee analysis of key performance metrics to identify areas in need of training and improvement, as well as the identification of potential workflow improvements.

*This position requires an onsite presence at our Meridian Idaho campus.

Required Experience:

7/+ years' relevant experience to include leadership experience. Preferred experience will be related to health, insurance and/or finance.

Preferred experience:

• Familiarity with applicable state and federal requirements (CMS, IDHW) related to enrollment and eligibility
• Have demonstrated skills managing in a complex environment interlinked within the enterprise
• The ability to recognize and leverage best practices and continuous improvement

Required Education:

Bachelor's Degree or equivalent work experience (Two years' relevant work experience is equivalent to one-year college)

As a Manager Service Operations in Enrollment & Billing Services, your will be:

• Implementing effective operational processes and leading process improvement work groups within the department and cross functionally. Measuring effectiveness of process changes and improvements.
• Developing and interpreting policies, procedures, service standards, and workflows to support the consistent application of practices and compliance with regulations.
• Ensuring that department milestones and goals are met.
• Providing direction for development changes of the applicable systems.
• Ensuring effective workflows, maximizing system efficiencies, monitoring quality performance measures, and confirming appropriate completion of work assignments.
• Optimizing staffing, processes, and operational controls by implementing staffing plans to meet Blue Cross of Idaho objectives and promoting a stable and proficient workforce, while managing and optimizing operational controls
• Providing guidance, counseling, and continuing education to staff. Selecting, developing, coaching, mentoring, and assessing performance of staff.
• In collaboration with senior leadership, designing, developing, and implementing focused functional area strategies.
• Assisting in preparing an annual operating budget that reflects the forecasted needs of the department and controls expenditures to assure adherence to approved budgets.
• Providing service operations support to other areas within the organization.
• Interpreting company and government regulations affecting the functional area and ensures compliance.
• Operationalizing EBS initiatives and making infrastructure and resource recommendations.
• Developing and managing department procedures, SLA's, and business rules.
• Working with service operations in other areas.
• Workflow management and coordination with IT and vendors
• Ensuring regulatory & Association requirements and business objectives are met.
• Implementing applicable business rules and requirements, ensure timeliness with regulatory deliverables are consistently met.
• Operational responsibility for compliance activities and associated reporting.
• Evaluating department performance, performing root cause analysis, and taking corrective actions.
• Responding to regulatory audits, inquiries, Internal Audit, and others.
• Performing other duties and responsibilities as assigned.

Reasonable accommodations

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.