Claims Systems Manager

Job Summary

Providing strategic leadership and oversight, the full-time remote Claims Systems Manager will manage a team of Systems Analysts responsible for the claims management system, ensuring alignment with organizational goals and facilitating effective project execution.

Key responsibilities

• Oversee and manage staff and vendor relationships related to system configuration, implementation, and support
• Provide project oversight, ensuring timely completion of Business Requirement Documents (BRDs) and vendor contracts
• Identify and define the vision and roadmap for the claims management system, aligning with strategic initiatives

Required qualifications

• Bachelor's degree in Business Administration, Information Systems Management, Health Information Management, or a related field
• Seven years of experience in management of data systems, with a focus on claims or health insurance systems preferred
• Five years of experience in a management or supervisory role
• In-depth understanding of physical and behavioral health claims processing software systems
• Knowledge of federal and state regulations, particularly North Carolina Medicaid laws