Health Insurance Operations Director jobs in Denver, CO

As Director of Service and Operations you oversee and manage end to end process for all customer-facing policy support needs, policy changes and actions, as well as premium changes and audits. This role is accountable for Pie's customer service quality, audit effectiveness, and receivables management. From a leadership perspective, you manage all customer facing, operational functions at Pie. You are responsible for developing the strategy to ensure successful delivery in our day to day operations (service levels, resolution rates, quality) and will lead an organization through growth & scale by setting a service vision, developing strategies and driving continuous improvement.

How You’ll Do It

• Manage end to end partner & policyholder policy experiences

• Identify gaps and needs for automation to create the best end to end experience. Create connectivity by collaborating cross-functionally within the direct functional areas as well as across other departments and functions that will influence direction, or could be impacted by strategy and direction within our departments.
• Responsible for the overall compliance of the program; fulfilling state requirements and diverse premium audit accuracy programs (driven by NCCI and Departments of Insurance).
• Accountable for the internal and external collection programs; managing through Managers and Analysts to maximize AR and reduce bad debt.

• Develop strategy for successful day to day deliverables

• Leading in program strategies, and overall responsibility for successful delivery of processes and tools.
• Responsible for overall scalability of programs success within functional areas.
• Responsible for managing and implementing operational work processes including improvement, efficiency, and technology-driven solutions and achieving operational excellence. As the key decision maker, this position is responsible for making final decisions on implementation and ensuring operational effectiveness.
• Uses Pie and CS data to inform and measure on the teams’ objectives, and track how the CS team influences Pie’s overarching OKRs.

• Drive efficiency at scale

• Works cross-functionally with UW, Product, Claims, Compliance, BD, Marketing, and Executives to deliver a best in class audit operation for our customer, partners, and internal team members to achieve Pie's financial goals.
• Oversee the development of processes that prioritize value added interactions or work while automating and reducing manual tasks.
• Partnering across the org to eliminate the need for help or service or enable automated resolutions.

• Build quality based programs that lead to retention

• Responsible for continuous improvement processes and encouraging the test and learn approach.
• Establish KPIs and managing to performance expectations
• Uses quality insights to drive improvement and push strategy on both people and processes within the organization.

The Right Stuff

• A Bachelor’s degree is required. Graduate’s Degree is preferred.
• 12 years of related experience in insurance, Insuretech, customer service, premium audit or other service based organization set up is required.
• 6 years of experience leading leaders or team management responsibilities is required.
• Strong data literacy experience including reading, working with, analyzing, and arguing with data.  Specifically, this individual needs to be able to:
  • Understand Data: know what data is and the ways it can be used.
  • Think Critically: ask the right questions about the data you see.
  • Evaluate Data: decide if the data is good quality and useful for what you need.
  • Use Data: be able to use tools and methods to do something with the data.
  • Ethical Considerations: understand the right and wrong ways to use data.
• Demonstrated experience working on projects involving redesigning how a company is structured, updating the technology everyone uses, or changing the way work gets done to be more efficient. Is comfortable making sure the organization is set up in the best way to meet its goals.
• Overall organization support using planning skills, problem solving skills, communication skills, and demonstrating adaptability while maintaining a results-focused approach to deliverables.
• Comfortable working in an agile-based workflow - working in a fast paced and flexible way of producing work and results. The need for collaboration, and continuous improvement, and supporting of the iterative process is essential here.
• Highly advanced leadership skills with demonstrated ability to create productive and positive work environments. Experience building career progression programs is highly desired.
• Demonstrated listening, and influence skills to build a culture of encouragement, and empowerment that cascades through the organization and other leaders.

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