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Business Process Owner Senior – Medicare Supplement Claims – Life Company

fully flexible
Remote: 
Full Remote
Contract: 
Salary: 
90 - 167K yearly
Experience: 
Senior (5-10 years)
Work from: 
Colorado (USA), Florida (USA), United States

Offer summary

Qualifications:

Bachelor's degree or equivalent experience, 6 years in business process execution, Experience in process improvement methodologies, Hands-on with Process Mapping and Modeling, 7+ years Medicare Supplement claims knowledge.

Key responsabilities:

  • Develop and implement strategic business processes
  • Lead problem definition, evaluation, and design of processes
  • Manage performance with control limits and KPIs
  • Identify and control operational and compliance risks
  • Provide mentorship and guidance to team members
USAA logo
USAA Financial Services XLarge https://www.usaajobs.com/
10001 Employees
See more USAA offers

Job description

Why USAA?
Let’s do something that really matters.

At USAA, we have an important mission: facilitating the financial security of millions of U.S. military members and their families. Not all of our employees served in our nation’s military, but we all share in the mission to give back to those who did. We’re working as one to build a great experience and make a real impact for our members.

We believe in our core values of honesty, integrity, loyalty and service. They’re what guides everything we do – from how we treat our members to how we treat each other. Come be a part of what makes us so special!

The Opportunity

We are currently seeking a dedicated Business Process Owner Senior that will support Medicare Supplement Claims for USAA Life Company Claims Operations.   This employee will report to the Life Company Chief Claims & Fraud Officer and will work on Medicare Supplement Claims activities and ensure a flawless execution of business-related processes, procedures, oversight and execution of the end-to-end claims process.  This role will work with our third-party supplier and key business partners supporting our Medicare Supplement Claims.  As business process owner, the employee will lead planning for complex processes including problem definition, evaluation of requirements, design, testing and implementation of business processes. This role will involve execution of any Issue Management matters for Medicare Supplement claim issues.

As business process owner, plans, directs, and coordinates activities for complex processes, including problem definition, evaluation of requirements, design, testing, and implementation of business processes. Understands the process operating objectives, business rules, performance requirements, risks, and controls and interactions between dependent processes to minimize failures, eliminate redundancies, and control process performance necessary to achieve efficient, effective design and execution of the process. Supports alignment of process to overall experience strategy and vision.

We offer a flexible work environment that requires an individual to be in the office 4 days per week. This position will be based in San Antonio, TX; Phoenix, AZ; Colorado Springs, CO. or Tampa, FL.   Relocation assistance is not available for this position.


What you'll do:

  • Develops and implements strategic customer specific business process program plans that align with enterprise strategy and influence appropriate roadmap(s).

  • Applies expert knowledge of the business and leads the alignment and development of business deliverable processes and capabilities to materially change and improve business performance.

  • Serves as functional expert bringing diverse perspective to leverage multiple ways of thinking while developing end-user focused process solution.

  • Manages the performance of processes by developing control limits, monitoring key performance indicators and informing stakeholders of any deficiencies, improvements, operational risks issues, etc. and drives collaborative efforts to ensure process delivers against requirements.

  • Identifies, owns, executes, enhances, and aligns controls to mitigate operational and compliance risks as it pertains to owned processes as it pertains to owned processes.

  • Develops communication plans for customers and internal stakeholders.

  • Ensures alignment between internal stakeholders and customers across all business process projects and services using proactive communication and engagement strategies.

  • Utilizes reporting, data, and analytics to measure process and project performance, deliver process operational efficiencies, and inform key stakeholders.

  • Stays current with emerging technologies and evaluates business processes to lead continuous process improvement efforts.

  • Lead solution development including business case / benefits substantiation and drive business requirements for process improvement initiatives.  

  • Provides mentorship and guidance support for team and applicable business partners.

  • Actively provides relevant business performance intel to progress the planning, research, analysis, development, and implementation of new and modifications to existing applications and processes to provide new or improved capabilities, products, and/or services.

  • Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.

What you have:

  • Bachelor’s degree OR 4 years of related experience (in addition to the minimum years of experience required) may be substituted in lieu of degree.  (Total of 10 years without bachelor’s degree)

  • 6 years business process execution/knowledge/experience, consulting, and/or process engineering/optimization.

  • Experience in successfully applying quality management, process improvement, and problem-solving tools and methodologies.

  • Experience in implementing and sustaining change/improvements (change champion).

  • Hands on experience with Process Mapping and Modeling and creating and validating process documentation.

  • Experience in the application of process management standards and policies, and knowledge of applicable regulations and risk management practices.

  • Demonstrated experience with Lean, Business Process Management, or similar methodology.

  • Demonstrated experience with utilizing various systems to collect and analyze data.

What sets you apart:

  • US military experience through military service or a military spouse/domestic partner

  • 7 or more years of Medicare Supplement/Medicare claims knowledge and/or experience

  • 7 or more years of experience working Medicare/Medicare Supplement and products

  • Working knowledge of Medicare State and Federal Regulations

  • Working knowledge of Medicare coding, billing, and allowed and denied services.

  • Knowledge and experience working Medicare Exhausted claims, and other categories of Medicare claim settlements

  • Knowledge of process, procedures and requirements related to Centers for Medicare & Medicare Services (CMS)

  •  Extensive experience working health claims and/or health insurance products with an insurance company.

The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job.

What we offer:

Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location. The salary range for this position is: $89,990 - $167,000

Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.

Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning, and continuing education assists employees with their professional goals.

For more details on our outstanding benefits, please visit our benefits page on USAAjobs.com.

Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting.

 

USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Required profile

Experience

Level of experience: Senior (5-10 years)
Industry :
Financial Services
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Problem Solving
  • Leadership
  • Verbal Communication Skills
  • Analytical Thinking

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