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Consulting Services & Project/Program Management (Non-IT)

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National Claims Administration Regional Service Liaison

Location: Oakland, CA Additional Locations:
Job Number: 717963 Date posted: 07/23/2018

The purpose of this position is to become engaged with the regional departments and provide excellent customer service to our regional partners.  This includes the active engagement at regional service area leadership meetings conducted by NCA leadership in conjunction with service area leadership.   This includes becoming a trusted partner of the regional service area leaders and provider contracting partnering with the leads to understand regional network strategies, and challenges. Act as a messenger from the NCA in various regional service area and provider contracting meetings; engage NCA leaders as needed in the regional meetings.  This position is based upon a need for strong collaboration to ensure superior service is provided to our members and providers. Working with the National Claims Administration team and CA regional service area leadership, the position will have regional service engagement responsibilities.

Essential Responsibilities:

  • Builds relationships with key service area and PMG leaders in region and partners with them to understand external network and other related initiatives, service request needs, strategies and challenges.

  • Partners with NCA leaders to provide the voice of the region during issue management, service requests related meetings and provider outreach interactions.

  • Provides transparency to the NCA leaders re: issues and areas for improvement.

  • Assists with external network readiness activities with regional and / or provider contracting leaders.

  • Participates in regional meetings with providers and / or provider contracting as needed to represent the NCA, when in-person is required.

  • Provides support during provider outreach and business review calls.

  • Provides hands-on support to regarding process and system challenges with claims related issues, engaging NCA team members when required for assistance.

  • Facilitates cross functional issue resolution for external provider claims related issues to include root cause analysis to ensure sustainable solutions.

  • Basic Qualifications:


  • Minimum six (6) years of process improvement, management consulting, change management, or related business experience.

  • Education

  • Bachelor's degree OR four (4) additional years of experience in a directly related field.

  • High School Diploma or General Education Development (GED) required.

  • License, Certification, Registration

  • N/A

  • Additional Requirements:

  • Broad knowledge of process improvement methodologies.

  • Client Services experience.

  • Project Management experience in achieving results through others in a complex matrix organization.

  • Industry knowledge of standard health plan operation processes and infrastructure.

  • Ability to see and understand end-to-end processes, cross boundary dependencies and 'down-stream' effects.

  • Ability to influence and persuade through large group presentations as well as small group communications.

  • Ability to gain confidence and support of customers.

  • Success in managing moderate to complex projects, affecting multiple stakeholders and applications, preferably in a multi-regional or multi-business unit organization.

  • Collaborative style with ability to engage multiple diverse stakeholders with differing views.

  • Ability to successfully work in a Labor-Management Partnership environment.

  • Must be able to work in a Labor/Management Partnership environment.

  • Preferred Qualifications:

  • Minimum nine (9) years of process improvement, management consulting, change management, or related business experience preferred.

  • Healthcare Claims experience

  • Graduate degree preferred.
  • Primary Location: California,Oakland,1800 Harrison 1800 Harrison Scheduled Weekly Hours: 40 Shift: Variable Workdays: Mon, Tue, Wed, Thu, Fri Working Hours Start: Varies Working Hours End: Varies Job Schedule: Full-time Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: Salaried, Non-Union, Exempt Job Level: Individual Contributor Job Category: Consulting Services / Project/Program Management (Non IT) Department: National Claims Administration: RSL Travel: Yes, 25 % of the Time

    About Consulting Services & Project/program Management (non-it) Careers

    Consulting Services & Project/program Management (non-it) Careers

    These careers consist of Program and Project Managers, Business Consultants, Business Analysts, and Data Analysts who all work together to effect positive organizational change from the inside out.

    Join our talented team and make a difference through performing business analysis, developing business cases, providing client support during system development and implementation, managing projects, or by leading complex programs with multiple work streams.

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