Job opening: Program Manager (Disputed Claims)
Salary: $163 964 - 191 900 per year
Published at: May 17 2024
Employment Type: Full-time
As a Program Manager (Disputed Claims) at the GS-0340-15, you will be part of Healthcare and Insurance, Office of Personnel Management. If selected, you will be responsible for directing the Disputed Claims Team operations, including the scheduling, achievement, and performance review of the team.
Duties
Provides overall leadership for group planning, organizing, mentoring, and overseeing operations of the Disputed Claims office.
Lead the procurement for the Independent Review Organization (IRO) contract for medical consultant reviews.
Develops and evaluates standard operating procedures on disputed claims operations.
Represents OPM in meetings with officials of other Federal agencies, public and private sector organizations, carriers or insurance companies.
Qualifications
For the GS 15: You must have one full year of specialized experience comparable in scope and responsibility to the GS-14 level in the Federal service (obtained in public or private sectors), which includes performing ALL the following activities:
Provide management oversight and control over a team adjudicating disputed claims;
Ensure disputed claims process is in accordance with statutory and regulatory requirements;
Handle staff and other complaints, settling disagreements and resolving conflicts; AND
Review communications and letters on health benefits claims.
You must meet all qualification and eligibility requirements by the closing date of this announcement.
Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community, student, social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience.
Education
This job does not have an education qualification requirement.
Contacts
- Address OPM Human Resources
1900 E St., NW
Washington, DC 20415
US
- Name: OPM Human Resources
- Phone: 202-606-9321
- Email: [email protected]
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