Director of Operations

Professional Benefit Administrators leads with one guiding principle, provide exceptional benefit administration for self-funded health plans. Brokers who choose to partner with PBA will benefit from an ally who values cost containment, flexibility, responsiveness, member advocacy, transparency, and results. PBA collectively aligns through the organization’s core values of: 

• Work together and respect each other,
• Be dedicated to the customer, 
• Be accountable and do what you say,
• Take initiative and be willing to learn and
• Generate positive energy.

The Director of Operations will be accountable for the Claims, Claims Acquisition, Enrollment, and Member Advocate teams working with PBA’s leadership team to set the course for PBA’s future. Must be an outgoing business leader who can observe, analyze, and continually improve the operation to ensure it runs as efficiently as possible for PBA's success. This role reports to the COO/Integrator. Please see below for a more in-depth overview of daily responsibilities and skills required for this position.

Responsible for: 

• LMA (Lead, Manage and support a culture of Accountability) using the EOS model.
• Developing, mentoring, and evaluating Operations staff including, but not limited to, annual reviews and Quarterly Conversations
• Oversight and accountability of the entire Operations team which includes: Member Advocacy, Claims Acquisition (claims prep, PPO liaison, provider maintenance, mail room), Enrollment and Claims (processing, training, auditing, excess and plan loading.
• Reporting department activity to Leadership team and COO/Integrator on a weekly basis
• Working with Leadership team to stay in front of governmental compliance issues and their implementation on behalf of clients.
• Coordinating resources and setting accountability within the department to accommodate the constantly changing environment.
• Applying observations and feedback to continually improve PBA’s operation.
• Team building
• All other duties as assigned.

Requirements for this position: 

• 5 years managing, supervising, coaching, and directing a similar service based or claims operation.
• 3 years managing Third Party Administration Claims processing.
• Stop loss experience or knowledge a strong plus.
• Javelina claims system experience or knowledge a strong plus.
• Senior level organizational, analytical and accountability skills are necessary.
• Effective verbal and written communications skills necessary to lead and grow all team members while supporting our clients and broker’s needs.
• Demonstrated ability to get results through team members and management.
• Adaptability to new concepts and systems
• Problem solver and critical thinker
• Open minded and desire to learn, grow and receive feedback in a welcoming way.
• Must be able to represent PBA’s Core Values and business procedures to vendors, brokers, and clients.

Essential Functions Statement

• This position may require you to be in the office up to two days a month for meetings, training, etc.
• The person in this position frequently communicates with co-workers, subordinates, customers and vendors via phone and email.

Professional Benefit Administrators is an equal opportunity employer. In accordance with anti-discrimination law, it is the purpose of this policy to effectuate these principles and mandates. Professional Benefit Administrators affords equal employment opportunities to all employees and applicants and specifically prohibits any and all discrimination and harassment based on race, race-related traits, color, religion, national origin, ethnicity, ancestry, military status, sex, pregnancy, sexual orientation, gender identity, disability (mental or physical), age, marital status, citizenship status, unfavorable military discharge, genetic information, order of protection status, and any other protected status under federal, state, and local law. Professional Benefit Administrators conform to the spirit and letter of all applicable laws and regulations.