sr. director insurance third party administration.

　　irving , texas

　　posted 8 days ago

　　job details

　　summary

　　$100 - $130 per hour

　　contract

　　bachelor degree

　　category business and financial operations occupations

　　reference508747

　　job details

　　job summary:

　　Tatum has a new Consulting Opportunity for a Sr. Director with a Health Insurance Administration & Claims processing Company in Irving, Texas. This TPA is part of a larger privately held group of companies with $150 million in revenue. The company does have a direct hire opening and would like to engage a consultant with the potential of becoming an employee for the longer term. The company has a hybrid work environment. The health insurance business portfolio mix is currently 90% individual and 10% group with a focus on growing the group segment.

　　location: Irving, Texas

　　job type: Contract

　　salary: $100 - 130 per hour

　　work hours: 8 to 5

　　education: Bachelor's degree

　　experience: 10 Years

　　responsibilities:

　　Provide Solution Support for financial viability, vendor management, claims administration, BPO Client Operations,medical management, network development, producer services, member services, audit management, and compliance.

　　Expand the company into the self-funded medical group healthcare market

　　Manage vendor partnerships and contracts; expand network relationships and develop new carrier relationships, assisting with due diligence, policy creation, and implementation.

　　Oversee compliance, auditing, and reporting while addressing legal and regulatory matters.

　　qualifications:

　　Qualifications:

　　Must have 5+ years management experience in a Healthcare TPA.

　　Must have specific experience regarding claims processing, adjudication, and payment

　　Operations leadership experience with claims and customer service

　　Able to be in the office in Irving, TX daily

　　Deep understanding of claims management and process improvement

　　Solid understanding of claims systems

　　Willingness to step into a challenging situation and role

　　Problem solver experience and mindset

　　Deep experience with measuring performance with metrics

　　Proven record of leadership

　　Development

　　Retention

　　Culture builder

　　Solutions driven

　　Values driven

　　Calming presence

　　skills: $0-50 million

　　Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

　　At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact [email protected].

　　Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including health, an incentive and recognition program, and 401K contribution (all benefits are based on eligibility).

　　Applications accepted on ongoing basis until filled.

　　get in touch

　　we are here to help you with your questions.

　　JP

　　john pollock

　　+1 972 200 3767 (tel:+1 972 200 3767)