SVP, Bill Review

September 16

Apply Now

Receive Emails with Similar Jobs

Sedgwick

WebsiteLinkedInAll Job Openings

claims management • risk management • workers'​ compensation • disability • absence solutions

10,000+

Description

• To plan, direct, control and oversee functions within Bill Review-Careworks • To maintain relationships with internal and external customers, the provider/network and other members of the vendor community • Designs, develops, and implements cost effective strategies promoting productive outcomes for Bill Review operations • Ensures quality performance of the bill review product to customers through monitoring the department quality outcomes • Creates and operates within the financial budget for operations units • Partners with key management team members from other corporate divisions to determine best practices, provide smooth interaction, and promote teamwork • Represents the company externally on bill review issues • Analyzes reporting tools allowing for strong oversight and controls • Analyzes organizational needs; determines any changes or updates to structure and staffing models • Establishes business plan with goals and objectives for offices/locations within assigned area • Establishes policy and procedures to assure compliance to best practices, claims management services standards, state regulations, and client service requirements • Partners with internal resources to direct the management of vendor performance • Performs other duties as assigned • Travels as required

Requirements

• Bachelor's degree from an accredited college or university required • Ten (10) years of experience and proficiency with workers' compensation legal and regulatory requirements and/or quality/managed care concepts • Seven (7) years of strong management or equivalent combination of education and experience required • Six (6) years of experience managing bill review preferred • Thorough knowledge of managed care processes and procedures • Thorough knowledge of state laws and regulations • Ability to oversee executive level client/account management and support • Excellent oral and written communication, including presentation skills • PC literate, including Microsoft Office products • Exceptional leadership/management/motivational skills • Analytical and interpretive skills • Strong organizational and time management skills • Excellent interpersonal skills • Ability to delegate responsibilities and duties • Ability to establish credibility and be decisive • Ability to meet or exceed Performance Competencies • Credit security clearance, confirmed via a background credit check, is required for this position

Benefits

• medical • dental • vision • 401k and matching • PTO • disability and life insurance • employee assistance • flexible spending or health savings account • other additional voluntary benefits