Leader, Cost Containment and Recovery

Full-Time, Exempt

Position is hybrid

JOB SUMMARY:

Responsible for financial recovery including recovery vendors and coordination of benefits for the organization. This role is responsible for leading all claims payment recovery activities, oversight and maintenance of all internal and vendor related workflows, all coordination of benefits activities. Accountable for the direction of recovery and collections programs identifying areas of opportunity for improvement. Partners with organization leads to influence policy and procedure best practices ensuring positive outcomes. Accountable for setting goals, metrics, and reporting to monitor and achieve/exceed expectations. Ensuring accuracy and compliance standards are met in accordance with policy and procedures are a key responsibility of this role. Leverages data and information to make recommendations and drive process improvements and monitoring. Develop a high performing team for success by providing guidance, training, and support is essential. Works closely with other departments, including Claims, Customer Service, Provider Network, and Legal, to resolve complex cases. Stay updated on industry trends and best practices. Propose and implement process improvements to enhance efficiency and effectiveness.

Minimum Education:

High School Diploma or GED. AAS degree preferred.

Minimum Experience:

Minimum of 5 years' experience in coordination of benefits, claims processing, or

recovery. 2 years supervisory experience preferred. Strong leadership and team

management skills. Strong understanding of healthcare regulations, compliance

requirements and best practices in financial recovery. Equivalent combination

education and experience may be considered.

Required Skills:

• Excellent analytical and problem-solving skills.
• Proficient in using claims processing software and other relevant tools.
• Excellent communication skills (verbal, written, interpersonal, presentation) with all levels of audience.
• Ability to work in a fast-paced environment and manage multiple priorities.
• Independent Adjusters License is required. (If not certified when hired into position, must obtain in the IAL training claim).
• Experience with process improvement methodologies such as Lean or Six Sigma preferred.

About MVP

MVP Health Care is a nationally recognized, not-for-profit health insurer caring for members in New York and Vermont. Committed to the complete well-being of our members and the communities we serve, MVP makes health insurance more convenient, more supportive, and more personal. We are powered by the ideas and energy of more than 1,700 diverse employees from all backgrounds, committed to having a positive impact on the health and wellness of everyone we serve.

At MVP, we are committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. Specific employment offers and associated compensation will be made individually based on several factors, including but not limited to geographic location; relevant experience, education, and training; and the nature of and demand for the role.

In addition, we offer a comprehensive benefits package that includes:

• Considerable paid time away from work including PTO (Paid Time Off), sick time, service time off, paid holidays, and floating holidays, allowing you to take time off when it suits you best.
• Competitive 401(k) employer matching and profit-sharing program to help you save for your retirement.
• Low premium health benefits including medical, dental, and vision coverage to support your well-being and that of your family.
• Life insurance and disability coverage to ensure financial security for you and your dependents.
• An array of optional benefit plans such as accident insurance and specified disease coverage to protect you from the unexpected.
• Full tuition reimbursement (up to the IRS limit) for approved courses and programs that support continuous learning.
• A best-in-class employee Well-Being program to support all dimensions of your health and wellness.

MVP Health Care analyzes the latest market data to determine employee compensation. Compensation figures listed in a job posting are subject to change as new market data becomes available. The salary range, other compensation, and benefits information is accurate as of the date of this posting. MVP Health Care reserves the right to modify this information at any time, subject to applicable law. More detailed information about totalcompensation and benefits will be provided during the hiring process.

MVP Health Care is an Affirmative Action/ Equal Employment Opportunity (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), and the Know your Rights protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at hr@mvphealthcare.com

Please apply and learn more - including how you may become a proud member of our team.

• Headquarters Office, 625 State Street, Schenectady, New York, United States of America
• Rochester Office, 20 S. Clinton Ave, Rochester, New York, United States of America