Collective Health is hiring a

Director, Health Plan Operations

Lehi, United States

We all depend on healthcare throughout our lifetimes, for ourselves, and our families and friends, but it is notoriously difficult to navigate and understand. As an industry that comprises 20% of the US economy we think healthcare should work better for all of us. At Collective Health we believe it’s time for a new day in healthcare where as members we are informed and empowered to make the right care choices when the decisions are urgent and critical. 

Collective Health is expanding its Customer Experience team in Utah! We believe health benefits should be simple, accessible, and technology-driven. But moreover, we believe healthcare should be grounded by the people that it serves. To accomplish this, we are reimagining the operational core of health insurance. We are seeking leaders to help deliver on this vision. 

We are hiring an experienced leader to lead and scale our Plan Operations team and processes. The Plan Operations team at Collective Health includes the back office functions to administer health plans. This includes appeals determinations, stop loss insurance reconciliation and reporting, medical/pharmacy partner operations and plan design teams. The ideal candidate will have health insurance experience and a deep understanding of health plan administration. This could include an understanding of claims adjudication, subrogation, appeals, stop loss and operations. This leader will have experience building an inclusive and engaged organization with a focus on developing leaders to reach their full potential. Experience scaling an organization with multiple functions is strongly preferred. 

While we are embracing a remote-flexible work week, employees are expected to be within commuting distance of an office. The  frequency of in-office days will be determined on a team-by-team basis closer to the reopening of our offices.

Key Responsibilities:

  • Leadership:
    • Create an inclusive and engaged team across the Plan Operations team
    • Develop the leadership team and building a world class operations team
    • Take ownership and work cross-functionally with multiple Customer Experience teams, Legal, Product, Engineering, and Client Success to identify and resolve issues
  • Operations:
    • Own and drive operational excellence and rigor within and across Plan Operations.
    • Directly responsible for all back office teams that support health plan administration, including Policies and Appeals, Payments, Stop Loss and Medical Network and Pharmacy Operations.
    • You will also be responsible the management of our Plan Structure and Launch team which is responsible for the implementation and renewal of Client’s Plan Designs and all corresponding Plan Artifacts (SPDs, SBCs, and Portals)   
    • Monitor and ensure timely resolution of member and client inquiries
  • Scaling:
    • Drive scalability across all functions and processes within Plan Operations.
    • Collaborate cross functionally to drive technology enabled solutions to enable the teams to scale. This includes partnering with teams across Product, Engineering, Product Operations and other teams as needed. 
  • Continuous improvement:
    • End-to-end analysis of systems and processes, identifying areas for improved efficiency, automation, accuracy and scalability
    • Create performance metrics across the various functions and drive operational excellence across the team 

Skills and Qualifications:

  • 10+ years of direct management experience, including multiple years of leading leaders 
  • Experience leading operations and service teams, preferably in high-growth technology and/or health insurance companies
  • Health insurance experience/health plan administration experience required
  • Experience implementing complex processes and projects
  • Experience working cross-functionally with Legal, Engineering, Product and Customer-facing teams
  • Experience working with various stakeholders including clients
  • Ability to make progress, recommendations and decisions despite ambiguity
  • Ability to understand, analyze and envision the end-to-end process
  • Member and client focused (customer centricity)
  • You enjoy a fast paced team environment and adapt well to change by adjusting priorities as needed
  • You have excellent verbal, written and interpersonal communication skills
  • You are analytically minded and like to make data-driven decisions
  • You are a self-motivator and self-starter
  • You are inspired by creating and fostering an engaged workforce

 

Founded in 2013, Collective Health has created an ecosystem of innovative partners across care and benefits delivery, as well as built a powerful and flexible infrastructure to better enable employees and their families to understand, navigate, and pay for healthcare. By reducing the administrative lift of delivering health benefits, providing an intuitive member experience, and improving health outcomes, the company guides employees toward healthier lives and companies toward healthier bottom lines. Collective Health is headquartered in San Mateo, CA with locations in Chicago, IL, and Lehi, UT. For more information, please visit collectivehealth.com.

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. Collective Health is committed to providing support to candidates who require reasonable accommodation during the interview process. If you need assistance, please contact [email protected].

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