Share this Job

Operations Manager Claims Testing

Date: 
Brand:  EyeMed Vision Care
Location: 

Mason, OH, US, 45040

Requisition ID: 214102 
Position:Full-Time

 

There’s more to EyeMed than meets the eye. EyeMed is the fastest growing managed vision benefits company in the country with consistent double-digit membership growth! Through our commitment to innovation, we’re reimagining the way employers and their employees think about vision care. We want them to see life to the fullest and experience more of what’s best, not more of the same.  And if what’s best hasn’t been done yet, it’s our exceptional and passionate employees driving this change. But, our passion for vision isn’t just about vision insurance benefits. Our employees are proud to support and participate in life-altering global and local missions through our partnership with OneSight, a leading not-for-profit organization with a 100% focus on eradicating the world’s vision crisis.

 

Your family says a lot about who you are. EyeMed is a key member of the Luxottica family of companies, global leaders in the design, manufacture and distribution of fashion, luxury and sports eyewear.  In North America, Luxottica is the home to global brands Ray-Ban, Oakley and many top fashion house brands.  Our leading retail brands include LensCrafters, Sunglass Hut, Pearle Vision, Target Optical and Sears Optical.

 

If you’re passionate about driving innovation and change and interested in a career in the optical and insurance industry, EyeMed wants to start the conversation and help provide you a growth-focused opportunity with America’s fastest growing vision benefits company.

GENERAL FUNCTION

The manager is responsible for all aspects of the operational claims testing process including transforming end to end testing process to drive claim processing accuracy, working closely with both technical and non-technical teams. Continuously identify opportunities to innovate using new approaches, tools and testing methodologies. Accountable for guiding the development of testing standards, as well as validating that the testing team is adhering to them. The role involves quality & test advocacy, resource planning & management, resolution of issues that impede the testing effort and assess & report progress and effectiveness of the test effort. Negotiate the ongoing purpose and deliverables of the test team while seeking continuous improvement and automation to increase efficiency and effectiveness.

 

MAJOR DUTIES AND RESPONSIBILITIES

  • Manage, organize and direct work activities for a team of testing analysts responsible for the completion of claims validation testing for external client requests, new client implementations and system stability testing
  • Lead the testing team to ensure test quality, progress, efficiency, effectiveness and sufficiency
  • Keep up to date of leading practices and innovation opportunities related to testing
  • Collaborate and partner with IT to identify requisite test automation tools
  • Identify and recommend systems/process improvements necessary to gain efficiency and effectiveness; provides project management oversight in the execution of these recommendations.
  • Provide resources for testing of key system changes and projects, ensure appropriate involvement, provide feedback to project leaders, ensuring alignment with standards and strategies
  • Manage and seek improvement opportunities related to the testing team, test methodologies, best practices, processes and tools
  • Report progress and health of testing and incorporate feedback from all stakeholders
  • Deliver reports to EyeMed leadership outlining performance relative to targets on a recurring basis, highlighting areas of risk and actions required to mitigate
  • Proactively identify and manage risks and issues pertaining to the project or testing initiative; identify claim issues and work cross-functionally to troubleshoot & resolve the underlying issue
  • Maximize performance of individual resources through on-going mentoring, coaching and employee development programs
  • Ensure claim processing standards, policies and desk level procedures are documented and current, ensuring appropriate controls & key compliance requirements are met

 

BASIC QUALIFICATIONS

  • Bachelor’s degree or equivalent work experience
  • 5+ years of process management experience
  • 3+ years of supervisory experience
  • Ability to multitask and manage project timelines
  • Highly proficient in SQL and Excel
  • Experience with process automation
  • Strong communication, problem solving, teamwork and organization skills

 

PREFERRED QUALIFICATIONS

  • Health industry background or knowledge
  • High-level understanding of regulatory and compliance requirements
  • Experience working with managed care claims or similar transactional data structures
  • Ability to communicate and present to executive leadership
  • Experience with continuous improvement, including knowledge of Lean/Six Sigma concepts
  • Working knowledge of systems, including: Facets, SAP, business objects and AS400

Upon request and consistent with applicable laws, Luxottica will provide reasonable accommodations to individuals with disabilities who need assistance in the application and hiring process.  To request a reasonable accommodation, please call the Luxottica Ethics Compliance Hotline at 1-888-887-3348 or e-mail HRCompliance@luxotticaretail.com (be sure to provide your name and contact information for either option so that we may follow up in a timely manner). 

We are an Equal Opportunity Employer.  All qualified applicants will receive consideration for employment without regard to race, color, gender, national origin, social origin, social condition, being perceived as a victim of domestic violence, sexual aggression or stalking, religion, age, disability, sexual orientation, gender identity or expression, citizenship, ancestry, veteran or military status, marital status, pregnancy (including unlawful discrimination on the basis of a legally protected pregnancy or maternity leave), genetic information or any other characteristics protected by law.  Native Americans receive preference in accordance with Tribal Law.


Nearest Major Market: Cincinnati

Job Segment: Operations Manager, Manager, Lean Six Sigma, Six Sigma, Operations, Management