Director, Payor Solutions Operations

Toronto, ON
$117,000-175,000 per year
Permanent
Full-time

1 month ago

DescriptionJoin our TeamAre 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

QualificationsYou'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.Salary Range: $117,000-$175,000Performance 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 usWe’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.HealthWe’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 recognized21,166
Physicians using TELUS Health electronic medical records6,300
Pharmacies using our pharmacy solutions140 million+
Health claims processed using TELUS Health solutionsAccessibilityTELUS 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.

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