Mgr Claims

Health Net, Inc. (NYSE: HNT) is among the nation’s largest publicly traded managed health care companies. Health Net’s mission is to help people be healthy, secure and comfortable. The company’s POS, HMO, insured PPO, behavioral health and government contracts subsidiaries provide health benefits to more than 7 million individuals. For more information on Health Net, Inc., please visit the company’s Web site at www.healthnet.com

 

JOB SUMMARY:


 

The Manager of Claims establishes and maintains the claims production staff to facilitate the corporate goals for measured standards.

 

ESSENTIAL DUTIES AND RESPONSIBILITIES: Maintains established claims production standards per production employee.Maintains established claims quality standards per production employee.Maintains established claims turn around time standards.Provides information regarding departmental staffing and budgeting requirements.Provides operational support when implementing new product lines, benefit packages or projects.Identifies system limitations and problems, makes recommendations for alternate work procedures.Provides benefit interpretations as relating to claims processing.Serves as a liaison to other departments.Identifies reporting needs and develops reports addressing the needs of claims management.Assumes other responsibilities as assigned by the Director, Claims Administration.



REQUIREMENTS:

 

Education:
Bachelor’s degree in Business Administration or a related field, or equivalent work experience.

 

Certification/License:

 

Experience:Minimum five years claims experience with two or more in a supervisory capacity.Minimum three years managed care experience.

Knowledge, Skills & Abilities:Excellent written and oral communication skills.Excellent interpersonal skills required.Ability to travel on short notice.Availability to work “off” hours.

OR
Any combination of academic education, professional training or work experience, which demonstrates the ability to perform the duties of the position.

 

Health Net, Inc. supports a drug-free work environment and requires pre-employment background and drug screening.

 

Health Net and its subsidiaries are an Equal opportunity/Affirmative Action Employer M/F/V/D.