Manager, Operations

Your Role

The Appeals and Grievances team is responsible for resolving our members concerns through a regulated process which includes accurately, timely and compliantly addressing each of the members concerns. The Operations, Managerwill report to the Senior Director of Operations. In this role you will In this role you will provide leadership and support to your team as well as interact with our members and specialty clients. You will also interact directly with our regulator, developing and presenting updates on case activity, discussing trends and observations as well as serving as a primary speaker for regulatory audit activity.

Your Work

In this role, you will:

• Responsible for a singular team, department or functional area. Scope of oversight includes planning, cost management and methods
• Demonstrate BSC Leadership Behaviors
• Foster a great place to work by clearly communicating mission, vision, goals, roles, and expectations for team members; celebrating team achievements; building successful working relationships across the organization
• Direct and control the activities of one or more smaller/less complex department(s) or functional area(s) through subordinate supervisors/team leads
• Establish operational objectives for department or functional area and participates with other managers to establish group objectives
• Ensure team processes are efficient and effective to manage case work timely and accurately
• Improve quality results through training and oversight
• Establish audit readiness across your team and in partnership with your peers

Your Knowledge and Experience

• Requires a college degree or equivalent experience and minimum 7 years prior relevant experience, including 3 years of management experience gained as a team leader, supervisor or project/program manager
• Understands basic management approaches such as work scheduling, prioritizing, coaching and process execution, work organization, risk management and delegation
• Understands Blue Shield of CAs mission and business plan
• Has functional expertise within the area of responsibility
• Requires advanced knowledge of job area usually obtained through advanced education combined with experience
• Strong knowledge of the Appeals and Grievances process
• Experience interacting with healthcare regulators
• Experience supporting or managing regulatory audits

Pay Range:

The pay range for this role is: $ 96,500 to $ 144,800 for California.

Note:

Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.

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