Director, Payor Solutions Operations, TELUS Health

Location: 

Toronto, ON, CA, M5J 2V5

Req ID:  49141
Jobs by Category:  Health
Job Function:  Health Solutions
Status:  Full Time
Schedule:  Regular

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

 

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.

 

 

Salary Range:  $117,000-$175,000
Performance Bonus or Sales Incentive Plan:  30%

Actual total compensation will be determined based on factors such as knowledge, skills, performance, experience and location. Additionally, TELUS offers rewarding benefits, which may vary per job function, such as:

  • Comprehensive total rewards package highlighting competitive salary and bonus structures, minimum 3 weeks of vacation, and flexible benefits plan to meet the needs of you and your family
  • Flexibility to work in-office, virtually or a combination of both
  • Generous company matched pension and share purchase programs
  • Opportunity to give back to communities in which we work, live and serve
  • Career growth and learning & development opportunities to develop your skills
  • And much more …

A bit about us

We’re a people-focused, customer-first, purpose-driven team who works together every day to innovate and do good. We improve lives through our technology solutions and foster a culture of innovation that empowers team members to solve complex problems and create remarkable human outcomes in a digital world. 

You’ll find our engaging, high-performance culture personally fulfilling, professionally challenging, and financially rewarding. We’re committed to diversity and equitable access to employment opportunities based on ability. Your unique contributions and talents will be valued and respected here. When you join our team, you’re helping us make the future friendly.

TELUS Health is an IT leader in Canada that focuses on the health sector. Our mission is to improve the way information is being used along the continuum of care to better the health of citizens in Canada and in selected countries.  

Disclaimer:  In accordance with the TELUS Health Solutions Data Center Security Policy, as a condition of employment, all team members whose job functions require they work at a Data Center and/or have access to detailed knowledge of technology related to client service delivery, are subject to a Personnel Security Screening conducted through the Government of Canada.

The health and safety of our team, customers and communities is paramount to TELUS.  Accordingly, we require anyone joining our TELUS Health Care Centres to be fully vaccinated for COVID-19.

Note for Quebec candidates: if knowledge of English is required for this position, it is because the team member will be asked, on a regular basis, to interact in English with external or internal parties or to use English applications or software as part of their tasks.

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.

 

 

 

 

Health

We’re looking for clinicians, programmers, product developers, sales and marketing people, customer support, and everyone in between. If you have a penchant for turning information into better health outcomes, then we want you to help us develop, implement and manage the most innovative healthcare solutions possible.

We are honoured to be recognized

21,166
Physicians using TELUS Health electronic medical records

6,300
Pharmacies using our pharmacy solutions

140 million+
Health claims processed using TELUS Health solutions

Accessibility

TELUS is proud to foster an inclusive culture that embraces diversity. We are committed to fair employment practices and all qualified applicants will receive consideration for employment.

We offer accommodation for applicants with disabilities, as required, during the recruitment process.