Director, Payor Solutions Operations

Description

Join our Team

Are you passionate about the healthcare industry, specifically solutions or technology supporting the group benefits industry, designing and executing programs to drive business and customer strategy and outcomes? Are you an aspiring leader who enjoys working collaboratively across the whole organization? If you are a strategic thinker who thrives on daily execution, customer experience and transformation, this is an exciting opportunity for you.

About the Role:

Reporting to the Vice President, Payor & Provider Operations, the Director – Payor Solutions Operations for claims management and adjudication, benefits administration and enrolment for both private and public sectors, will be responsible for the sustainment and evolution of the operations including performance measures; optimization initiatives to enhance the customer service delivery model and overall customer experience.

Key Responsibilities

• Lead business operations for all key customers in both the private and public sectors
• Lead claims management and adjudication, benefits enrolment and administration all key functional streams supporting daily insurers, third party administrators and vendors
• Design and lead strategic operational programs spanning strategy, planning, execution, with a focus on operational service excellence
• Drive the development and evolution of strategic programs such as automation to increase team capacity and scalability
• Optimize our operational structure and delivery model as the business evolves
• Coordination and collaboration with TELUS Health business units to ensure business goals are being delivered and optimal business outcomes are being achieved; savings, revenue generation and strategic alignment
• Support contractual amendments, RFPs and contract renewal and governance
• Lead service improvement plans and contract performance monitoring and reporting such as KPIs, SLA/SLOs
• Oversight and reporting on monthly operational performance and quarterly reviews
• Oversight on all operational escalations including clear actions to resolution
• Develop data-driven models that are used at an executive level for decision making
• Lead or support client communication materials that follow a logically reasoned, data-supported approach as needed
• Lead the customer service management function including its involvement with customer change requests, requirements gathering, business impact analysis and prioritization
• Remove obstacles and drive fundamental change within the assigned team to achieve overall business objectives, business buy-in and drive for an optimal customer experience
• Support new business implementations or migrations
• Leads operational change management efforts and supports other business key program change efforts as new programs are introduced, or existing evolves
• Lead all customer monthly or quarterly business reviews for respective area of responsibilities
• Lead all negotiations in support of all operational contract management and vendor renewal agreements

Qualifications

You're the missing piece of the puzzle

• Bachelor's degree in business administration, healthcare industry or equivalent experience. An advanced degree (MBA or equivalent) is an asset
• 7+ years in a business and people management capacity, leading a team of 50+ employees
• Solid understanding of the Payor market, primarily group benefits insurance industry with related experience
• Extensive leadership experience with proven track record of leading key functional operational streams including developing and leading high performing, highly engaged teams
• Leader focused on business transformation, with key proven experience with AI and automation
• Proficiency in both French and English, with strong written and oral communication skills in both languages
• An exceptional communicator, influencer and negotiator, able to build and maintain effective partnerships internally and externally with all stakeholders, including senior leaders
• Strong business and financial acumen with experience in budget, capacity planning, forecasting and cost efficiencies.
• Extensive experience in business transformation
• Experience with a matrix organization in a fast paced environment is preferred

Here’s what makes you the ideal candidate:

• Exceptional relationship-building, collaboration, and influence skills at all organizational levels and across multiple teams
• Demonstrated success in delivering exceptional customer experiences and achieving high levels of operational efficiency
• Strong organizational, presentation, and communication skills, with the ability to convey complex strategic concepts clearly
• Superior strategic planning, performance analysis, and program/project management skills, with a focus on transformative initiatives
• Passion for working in a dynamic, high-performance culture, with a commitment to continuous improvement and innovation

What We Give Back to You:

• Opportunities to excel – work on high value and high visibility initiatives
• Flexible work styles with the ability to work in and out of the office
• Work in an organization that actively supports you giving back to the community you live in
• Competitive pay and benefits
• A workplace that lets you be your best everyday and embraces our core values: passionately putting our customers and communities first, embracing change and innovating courageously, and growing together through spirited teamwork

Intermediate knowledge of English is required because you will most of the time interact in English with external parties (clients, suppliers, candidates, external partners, etc.); interact in English with internal parties (colleagues, internal partners, stakeholders, etc.); and work with IT tools whose interface is only accessible in English as part of this position's main responsibilities given its national scope.

By applying to this role, you understand and agree that your information will be shared with the TELUS Group of Companies’ Talent Acquisition team(s) and/or any leader(s) who will be part of the selection process.