About the Company:
Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services’ self-funded employee health benefit plan. As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services’ mission of Building Healthier Communities Together.
About the Role
:Oversees and manages the strategic operations of the Claims, Enrollment, and Provider Data Management departments. Ensures the accuracy, efficiency, and compliance of all related processes, driving improvements and innovations to support organizational goals. Works closely with internal and external stakeholders to ensure service excellence, operational efficiency, and regulatory compliance
Responsibilities:
- Ensure accuracy, efficiency, and compliance of Claims, Enrollment, and Provider Data Management departments
- Drive improvements and innovations to support organizational goals
- Work closely with internal and external stakeholders for service excellence, operational efficiency, and regulatory compliance
Qualifications:
Bachelor’s degree in Healthcare Administration, Business Administration, or a related field; or equivalent experience required. Master’s degree preferred. Five (5) years of experience in claims processing, enrollment, and provider data management within a managed care organization or a similar healthcare setting required. Three (3) years leadership experience required. Experience with healthcare regulations, including Medicare and Medicaid, required. Experience in healthcare management systems and data analytics tools required
Remote Opportunity:
We are open to remote out of state work in any of our approved states: Alabama, Alaska, Arizona, Arkansas, Connecticut, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, or Wiscosin
Pay range and compensation package
Not specified
