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Senior Consultant Claims & Operations SME

Company: Impresiv Health
Location: Sanford
Posted on: November 18, 2022

Job Description:

Senior consultant, Claims/operations SME
Built by industry experts, Impresiv Health is an organization that has excelled in the medical staffing and consulting arena by possessing a high-quality clinical acumen, proven strategic guidance and providing timely service. Impresiv Health has provided real results and thus has seen real growth experiencing a 203% growth in 2021 within a three-year window. We're a collaborative company that puts an emphasis on culture, ensures individual development leads to internal elevation, embraces an inclusive environment, rewards effort and provides the necessary support to achieve results as well as ensuring that we give support to the communities we serve. We hope to provide our prospective new employees with not just a job, but with a positive fresh start within the journey of your career. If you are passionate about your career and have high expectations for your future, we'd love for you to join our team!

Key Job Description:

The Senior Consultant, Claims/Operations SME will provide their expertise and guidance to our clients through the Impresiv Health Project Team. This individual is expected to drive a highly collaborative environment by understanding the client's business operations, corporate goals and regulatory requirements making accurate and thorough recommendations to meet project scope and deliverables in a timely and efficient manner. This individual will demonstrate expertise in their field, be skilled in identifying problems and presenting well thought out solutions. They will also possess well-honed research skills, focus on details and be creative in solutioning.

Reporting to the President of Consulting Services, You Are Expected To:


  • Collaborate with a project team and clients, who will be the primary decision-makers, gaining a complete understanding of their specific goals, objectives and desired outcomes.
  • Provide guidance and industry expertise to the client and the Impresiv Health project team members in support of overall project goals. Stay acutely aware of changing industry trends in the development of new solutions and technology by the leading solution suppliers.
  • Aggressively investigate, advocate and define client requirements in the selection and eventual implementation of a core administrative system solution that meets or exceeds current and future client expectations.
  • Become extremely familiar with, and modify as necessary, the Request for Proposal document prior to its distribution to potential vendors.
  • Work closely with client leadership to ensure that their expectations are clearly defined and understood by both the Client and Project Team.
  • Work with the Project Team to ensure the early identification of potential problems and always offering clear, logical and expertise-based solutions.


    We'd Love to Hear from People Who Have:


    • Experience working for a Consulting Organization or having managed an implementation team
    • BS degree and 10+ years of Health Insurance/Plan Operations experience (preferably managing a high volume claims operation/configuration)
    • A thorough working knowledge of various industry leading claims administrative platforms (Facets, QNXT, HRP etc.)
    • Demonstrated deep knowledge of state and federal regulatory requirements as they apply to the prompt and accurate administration of health claims.
    • Strong analytical skills with the track record of driving change and process improvements
    • Demonstrated ability to adapt to new technologies and changing environments
    • Demonstrated leadership skills with the ability to work as part of a project team
    • Excellent written and verbal communication, with the ability to work with all levels of individuals in an organization
    • Ability to travel up to 20% as necessary to meet client needs.
    • Proficient in Microsoft Office applications, including Outlook, Microsoft Word, PowerPoint and Excel
    • Ability to develop clear and concise written communications for both internal and external communication

      What You'll Bring:


      • Deep and up to date industry expertise and knowledge
      • Strong verbal and written communication skills
      • Problem-solving skills
      • Ability to develop clear and concise written communications for both internal and external communication

        What We Offer:


        • Health: Medical, dental and vision insurance, life, accident and disability insurance
        • Wealth: Competitive pay, incentive opportunity, 401(k)
        • Growth: Developmental opportunities throughout our Promote from Within Culture
        • Balance: Paid-time off, parental leave, flexible work-schedules



          EEO/AA Statement:
          Impresiv Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
          This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.




Keywords: Impresiv Health, Sanford , Senior Consultant Claims & Operations SME, Professions , Sanford, Florida

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