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Director Claims Administration

Employer
York Risk Services Group
Location
Dublin, Ohio
Salary
Not Specified
Closing date
Mar 25, 2019

Job Details

At York, we believe that an experience marked by expertise, consistency and compassion sets us apart. And we celebrate the diverse backgrounds and unique perspectives that allow us to stand apart from our competitors. Thats why we are committed to recruiting, developing and retaining people who represent our values and who believe in our mission.

Job Description


Manage business operating plan(s) with a focus on operational quality and efficiencies of the
State Fund Teams
Develop, manage and maintain staffing plans to support business objectives
Monitor, evaluate, and assist in achievement of performance standards
Ensure all timeframes are met with quality review
Provide staff leadership by coaching, evaluating, identifying and recommending
professional growth opportunities and recognizing successes
Provide leadership and training to build a high performing team
Challenge others to develop as leaders by acting as a role model
Ensure URAC standards are maintained as indicated in the CareWorks policy and
procedure manual

Responsible for P&L management, meeting both financial performance and budgetary
objectives within the MCO Claims organization
Responsible for the successful development, implementation, outcomes and performance
tracking of specific MCO and BWC initiatives
Collaborate with Sales and Service teams on development and execution of customer retention
plans
Proactively collaborate with other internal departments on resolution of escalated issues,
complaints or compliance
Maintain customer relations and enhance company growth by networking, attending meetings,
and making presentations
Monitor compliance with federal laws and rules, Ohio workers compensation laws and rules,
and URAC case management standards
Establish and ensure compliance with performance standards and benchmarks for the MCO
Claims organization
Understands and practices within the scope of his/her license
Maintain URAC standards as indicated in the CareWorks policy and procedure manual

Qualifications
5 years of experience within the Ohio Managed Care Industry
5+ years of direct management experience
Strong leadership skills
Strong verbal and written communication skills
Demonstrated customer service skills
Demonstrated critical thinking skills

Experience leading and managing projects

Company

For more than 55 years, York has been delivering on our mission of reducing risk and getting people and organizations back to health, work and productivity. We’re committed to recruiting, developing and retaining people who represent our values and who believe in our mission. Our associates come from all walks of life but are single-minded in the pursuit of doing right by those we serve. We want each experience for our clients to be marked by expertise, consistency, and compassion because that’s what sets us apart. And we know for certain that it’s our people who allow us to say, boldly and proudly, that York is behind every good outcome.

Company info
Website

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