Claims Quality Manager

Job Summary

Leading a team in a telecommuter capacity, the full-time salaried Claims Quality Manager will oversee claims quality improvement, knowledge management, training, and performance monitoring to ensure high-quality outcomes and continuous improvement in healthcare claims processes.

Key responsibilities

• Build and lead a systematic approach to quality improvement across Claims Operations, leveraging operational data and customer feedback
• Establish and govern consistent knowledge management and training practices to prepare employees for evolving claims processes
• Monitor operational performance and collaborate with production leaders to implement corrective actions and improvement plans

Required qualifications

• A bachelor's degree or four years of relevant work experience
• Seven years of health plan industry or business/operational experience
• Four years of experience leading and managing teams of direct reports
• Experience using data and continuous improvement practices to drive operational outcomes
• Experience building or governing knowledge management and training programs