Director, GBCARE Operations (Bill Review) - Gallagher

Join our growing team of dedicated professionals at Gallagher Bassett, who guide those in need to the best possible outcomes for their health and wellbeing. You'll be part of a resilient team that works together to redefine the boundaries of excellence. At our organization, we value collaboration and making a positive impact in the lives of our clients and claimants, offering you the opportunity to join a team where your skills and dedication can truly make a difference. GUIDE. GUARD. GO BEYOND.

We believe that every candidate brings something special to the table, including you! So, even if you feel that you’re close but not an exact match, we encourage you to apply.

Under general direction of GBCARE leadership, this position will be responsible for operational management and client delivery for many aspects of the GBCARE Bill Review product.

This role will have the core responsibility for managing and enhancing the end-to-end Bill Review product from medical provider bill intake, to managing medical bill repricing, through payment and customer service. To accomplish this, the candidate must have extensive experience in project management, process optimization, and vendor/operational oversight. The team is looking for an independent self-starter, ideally with significant experience in medical bill review and provider networks, that will work cross-functionally with all Gallagher Bassett departments for product delivery.

Product Oversight and Project Management

• Optimize and oversee end-to-end processes, including medical bill intake/indexing, Medical Bill Review, and provider payment
• Monitor market trends and identify product enhancement or partnership opportunities to optimize client outcomes
• Where identified, lead new vendor and service introduction, including developing and implementing new processes and procedures for service offerings
• Serve as project manager for internal managed care change initiatives
• Lead selected process optimization efforts in cooperation with internal and external stakeholders

Vendor Oversight

• Where outside partners are engaged, responsible for negotiating and contracting select partner agreements
• Review vendor invoices and confirm payments where appropriate
• Confirm and oversee that product delivery matches agreed upon SLAs, including daily oversight and exception management

Department Liaison

• In partnership with all internal departments, develop workflows that drive greater efficiency and effectiveness
• Support efforts with Finance where needed to support pricing, forecasting, and audit
• Partner with IT to ensure new process requirements are defined and met, and support IT security and audit requirements
• Partner with Legal and Compliance for contracting, state regulation, and legal escalation concerns
• Partner with Sales and Client Services on marketing product benefits and value proposition, and managing client requirements

Escalation Management

• Manage significant escalations to completion, engaging all needed departments and partners

Preferred: 

• Extensive experience with Workers’ Compensation bill review and network access processes
• Prior vendor management experience
• Strong oral and written communication skills
• Project Management
• Ability to support the category lead in transformational planning and the development of business cases
• Highly collaborative and comfortable leading cross-functional efforts

Required:

• Bachelor's degree; 6 years related experience in claim reporting or workers compensation/managed care.
• Proficiency in computer applications, including risxfacs.com, Outlook, Excel, Word, PowerPoint, and Access.
• Strong organizational skills-must be able to prioritize workload and manage multiple tasks simultaneously.
• Excellent written and oral communication skills.
• Willingness to travel up to 50% of time.
  
  

#LI-HL1

On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits. 

 Below are the minimum core benefits you’ll get, depending on your job level these benefits may improve:

• Medical/dental/vision plans, which start from day one!
• Life and accident insurance
• 401(K) and Roth options
• Tax-advantaged accounts (HSA, FSA)
• Educational expense reimbursement
• Paid parental leave

Other benefits include:

• Digital mental health services (Talkspace)
• Flexible work hours (availability varies by office and job function)
• Training programs
• Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing
• Charitable matching gift program
• And more...

We value inclusion and diversity

Click Here to review our U.S. Eligibility Requirements

Inclusion and diversity (I&D) is a core part of our business, and it’s embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work.

Gallagher embraces our employees’ diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest.

Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non-conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected (herein referred to as “protected characteristics”) by applicable federal, state, or local laws.

Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business.