Head of Business Operations - Remote

Claims Supervisor The Claims operational teams are responsible for ensuring claims are processed accurately and adjudicated in accordance with member benefits, provider contracts, and organizational policies and procedures. The Claims Supervisor reports to the Senior Manager, Operations. As a Claims Supervisor, you will be responsible for the daily inventory of claims and assignment of work among claims examiners and the team's contractors. You will also work closely with the Senior Manager, Operations in developing process improvements and collaborating with other units to ensure the Claims Department meets and/or exceeds performance standards.

We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Manage a remote team while showcasing an understanding of basic supervisory/management approaches such as work scheduling, prioritizing, coaching, performance management, and process execution.

Foster a great place to work, communicating clear roles and responsibilities and building successful working relationships across the organization.

Consult and make recommendations to management on operational issues to improve performance on operational challenges that result in a stronger customer experience and self-service capability. Consistently achieve team performance metrics showcasing best in class service experience including but not limited to voice of the customer survey results, quality, and production.

Assist in the development and maintenance of training documents.

Organize the team workload and ensure claims inventory is appropriately assigned.

Conduct analysis related to claims processing activities and determine root causes of claims suspensions and payment errors.

Bachelor's degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree required

2 years of experience operating in a lead role or equivalent leadership training or manager training required

This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.

Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.

As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.

To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. News Best Company to work for, a Deloitte U.Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities join us!

We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. For most teams, this means coming into the office two days per week.

Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in-office time based on business need.

For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.

The Company reserves the right to require more presence in the office based on business needs, and requirements are subject to change with periodic reviews.

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.