Director, Business Services

Unity Health Insurance Madison , WI 53706

Posted 2 months ago

Quartz is seeking an experienced health insurance leader to oversee our Business Services department, responsible for the set-up and maintenance of the Quartz provider database and provider pricing applications. This position will provide work direction, while establishing and maintaining department-level audit controls to ensure financial accuracy and data integrity of the provider database system.

Key Responsibilities:

  • Oversee department staff, including selection, development, motivation, training and retention; identify and implement strategies to make department roles challenging and interesting. Ensure appropriate distribution of workload and develop employees toward career paths to benefit individual employees and long-term company goals and values.

  • Develop specific short and long term operational service strategies to maintain inventory levels to meet corporate goals.

  • Implement sound and effective cost saving strategies as it relates to claim coding compliance, claim investigative activities, monitoring and implementation of industry payment methodologies.

  • Develop, implement, maintain departmental level audit controls and change management procedures to ensure the accuracy and integrity of the data being entered and maintained in the core system and provider database.

  • Meet or exceed identified goals/standards related to quality and productivity for provider contract and provider record configuration while adhering to regulatory guidelines and standards and ensuring financial accuracy.

  • Work with external vendors to ensure utilized software is managed and used to its maximum capacity; Secure and maintain vendor relationships including review, analysis and negotiation of vendor contracts.

  • Ensure alignment with business requirements and goals as it relates to core system modules, data warehouse, business goals and quality standards.

  • Develop and manage the department annual budget, achieving cost efficiencies to increase corporate profitability.

Qualifications:

  • Bachelor's degree in Finance, Health or Business-related discipline

  • 5+ years of technical experience related to system audit controls or provider maintenance in the health insurance or managed care field

  • 5+ years of experience leading other staff

  • Certification in Epic core, AP claims and contracts or in Finance or Audit Controls is preferred

  • Excellent verbal and written communication skills, with the ability to interact effectively with internal staff and external parties

  • Strong knowledge of business planning, team building and effective operational efficiency techniques

  • Provide system configuration and set-up experience; ability to lead team members to achieve system strategies

  • Ability to oversee staff at multiple locations and travel to other office locations, on occasion, as needed.

Applicants for this position will have the option of working full-time from one of our offices in Madison, Sauk City or Onalaska, WI. Quartz offers an excellent benefit and compensation package, opportunity for professional growth and a professional culture built upon the foundation of Respect, Responsibility & Relationships.

Quartz values and embraces diversity and is proud to be an Equal Employment Opportunity, Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, gender identity or expression, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.


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