Director of Systems Configuration
We exist for American workers and their employers -- who are the backbone of our economy. That is where Centivo comes in -- our mission is to bring affordable, high-quality healthcare to the millions of Americans who struggle to pay their healthcare bills.
Centivo is seeking a well-rounded professional with 15+ years of experience in the Healthcare and Medical Insurance industry to lead systems integrations and manage cross-functional team processes for our TPA clients. The ideal candidate will have progressive and extensive experience in claims operations, plan benefit and network contract network configurations and related administrative configurations. This position will have oversight of the teams performing all System Configuration, Enrollment and Plan Documents duties, and will interface with the Quality Review Department. This position will be located in our Buffalo, NY office.
- Claim system configurations for client benefit plans, including enrollment, account structure, medical benefit plan design and provider network configurations.
- Network configurations for network contracts including Centivo’s proprietary network as well as leased PPO networks.
- Liaise with claims, concierge, provider configurations, care management and stop-loss management.
- Work with different members of leadership to meet client needs
- The ability to design solutions or paths that consider future changes in health care, not just a specific client configuration
Required Skills and Abilities:
- Four-year college degree
- 10 years of Claims Operations, with strong knowledge of the US employer-provided health insurance industry
- Plan building
- Provider network
- Claims System configuration
- Creative problem solving
- Strong self-funded industry knowledge
- Process and performance-driven leadership experience
- development and marketing of self-funded medical products
- Ability to prioritize and handle multiple tasks in a demanding work environment
- Comfortable with ambiguity and working without well-established policies and practices
- Willingness to stretch beyond defined roles to assist where needed
- Candidates with 5+ years of experience in Integrated Technology services and solutions
- Experience working with TPA’s
- Building and training customer service teams to be providers of world class service
This position will be located in our Buffalo, NY office.
To determine our range, we consider as many of the following data points as are available to us: external market salary survey data, internal data in terms of comparable roles and our budget for the position. Compensation is both an art and a science (as is negotiating a salary for a new job at a new company!), so what we have posted is our good faith estimate of what we expect to pay. We encourage candidates to apply for positions that are of interest and share their desired salary. We consider that as an additional data point, along with candidate skills and qualifications as part of our process.
Who we are:
Centivo is an innovative health plan for self-funded employers on a mission to bring affordable, high-quality healthcare to the millions of working Americans who struggle to pay their medical bills. Anchored around a primary care based ACO model, Centivo saves employers 15 to 30 percent compared to traditional insurance carriers. Employees also realize significant savings through our free primary care (including virtual), predictable copay and no-deductible benefit plan design. Centivo works with employers ranging in size from 51 employees to Fortune 500 companies. For more information, visit centivo.com.
Headquartered in Buffalo, NY with offices in New York City and Buffalo, Centivo is backed by leading healthcare and technology investors, including a recent round of investment from Morgan Health, a business unit of JPMorgan Chase & Co.