Curative is reimagining health insurance with $0 out of pocket costs and by reducing barriers to people seeking care. Help us create a better healthcare experience for our members by making it easy & intuitive for them to access the care they need. Curative is rapidly growing and is raising the bar in what people expect from their health plan. Were looking for someone who can think creatively and scale growing health plan operations.
Essential Functions:
- Oversee successful functioning of health plan operations systems endtoend including provider load plan configuration claims enrollment eligibility employer group and provider operations
- Monitor production environments prioritization schedules issue resolution and vendor interfaces to optimize quality reduce downtime and increase efficiency and work with Tech team for problem resolution and productivity improvements
- Work closely with business stakeholders to resolve any issues with systems and applications functionality both internally and across vendors
- Maximize health plan operations performance across systems to drive efficiencies creating market leading quality and operational administrative cost structure
- Identify technology automation and artificial intelligence application for health plan back office functions for improved scalability and speed to market
Responsibilities:
- Think creatively and scale growing health plan system operations
Identify OKR KPI quality and monitoring performance metrics resulting in superior health plan operations delivery in configurations claims employer group and provider support - Drive appropriate SLA and vendor performance metrics for high performance end to end system functionality
- Identify next level improvements to scale efficiently and effectively through AI and automation strategy development of both internal and external capabilities (vendor BPO claims edits)
- Form strong relationships with technology team to drive system and technology efforts for market leading operations
Please reach out if this describes your experience:
- Expertise in claims configuration eligibility and other health plan operating systems
- Experience in health plans system vendor oversight and monitoring
Qualifications
- 10 years proven track record of health plan operations technology and system deployment
- Experience in Health Edge and Health Rules Payer is extremely helpful
- 10 years of successful technology maintenance oversight
- Bachelors Degree
- Remote position with occasional travel
Required Experience:
Director