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VP Member Service & Claims | GM

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Tampa, FL
$170,000 - $180,000
Job Type
Direct Hire
Aug 11, 2017
Job ID

VP Member Services & Claims  | GM  – TAMPA

Health plan:  growth in new division has created a demand for an executive who is on the fast track and is prepared for increasing responsibility in leadership and quick advancement.  

Generous relocation package and rich benefits- UNLIMITED growth.

Broad span of operational control with newly established division of major corporation.  You will need broad - based experience in call center, claims, provider network management, analysis/reporting of data, office services to qualify.  Work history should demonstrate aggressive upward mobility.

Oversee business operations, procurement opportunities, new product implementations and complex initiatives for business development utilizing cross-functional business units and corporate teams to meet business unit and corporate strategic objectives.
Ownership for operations, claims, customer service (call center) office services and network development/provider relations, credentialing, reporting/data (encounters) mining, client relations/communications, etc).
Partner with multiple stakeholders and leadership to establish strategic visions, operational objectives, and policies and procedures ensuring compliance with state contracts, related laws, regulations and executive orders.
Monitor and report achievement of committed action plans to senior management.
Direct the development and implementation of operational work processes and systems with direct oversight for multiple departments within the business unit.
Accountable for budget, revenue targets, and Profit & Loss.
Lead and oversee new business implementation and procurement activities for all products and complex projects, including RFP responses.

 Evaluate program opportunities and recommendations for effectiveness and ROI.


-Bachelor's degree in Business Administration, Finance, Accountancy or a related field.

-9 + years of operations, management, or administration in the Health Insurance industry
-3+ years as a Director, Sr Director or VP required – with oversite for 50 + FTE’S

-  Extensive knowledge of state legislative and regulatory processes.
-  Experience organizing and leading a call center or claims center for a health plan or MCO