Manager, Operations
Blue Shield of California · Rancho Cordova, California, US
Your Role The Provider Dispute Resolution (PDR) Operations team manages and processes provider disputes across the Commercial, Medi-Cal and Medicare lines of...
Job description
Your Role The Provider Dispute Resolution (PDR) Operations team manages and processes provider disputes across the Commercial, Medi-Cal and Medicare lines of business and the No Surprise Billing(NSB) process. The team also partners with an offshore vendor to complete provider disputes and other strategic projects. The PDR Operations Manager will report to the Director of PDR. In this role you will be responsible for ensuring PDR and NSB inventory stays within compliance and regulatory guidelines, manage both onshore and offshore teams, and partner with the PDR Regulatory Audit Manager to create efficiencies in procedures, systems, and develop and implement strategic initiatives that will enhance the PDR department. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning. Your Work: In this role, you will: - Be responsible for the PDR Operations team over the Commercial, Medi-Cal and M...