Director of Operations

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 (Customer Service)
  • Claims Acquisition
    • Claims Prep
    • PPO Liaison
    • Provider Maintenance
    • Mail Room
  • Enrollment
  • Claims
    • Claims Processing
    • Training/Auditing
    • Excess stop loss claims
    • Plan Loading
    • Medical Management navigation between PBA and UR Vendors
• 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.
• Stoploss 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 brokers 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.

Human Resources / Office Coordinator (hybrid)

PBA is looking for a highly organized, detail-oriented and proactive HR/Office Coordinator to join our team. In this role, you will support our HR department in carrying out various HR programs and procedures as well as be responsible for ensuring the smooth operation of our office environment. The ideal candidate will have strong organizational skills, excellent communication abilities, and a passion for HR practices.

Responsible for

• Assist with the recruitment process by posting job openings, reviewing resumes, and scheduling interviews
• Maintain HR records, such as employee files and databases
• Assist in the onboarding process for new hires, including conducting orientation sessions
• Process employee changes (promotions, transfers, terminations) and ensure proper documentation is completed
• Assist in administering employee benefits and programs, including new hire enrollment, open enrollment and terminations
• Coordinate onsite/offsite meetings and workshops, including food, logistical arrangements and tracking attendance
• Handle inquiries from employees regarding HR and office related matters
• Prepare HR-related reports as needed
• Produce and distribute correspondence memos, letters, faxes, and forms
• Spend two days a week/ 3-4 hours supporting mailroom and back up when needed
• Order office equipment and supplies (including kitchen restock)
• Greet and provide general support to visitors
• Other duties as assigned

Requirements for this position

• 2+ years’ experience as an HR coordinator, HR administration, office administrator, office assistant, or relevant role
• Prior experience/exposure with payroll systems (Paylocity a plus)
• Outstanding communication and interpersonal abilities
• Excellent organizational and leadership skills
• Familiarity with office management procedures and basic accounting principles
• Proficient in MS Office (especially Excel and Word)
• Knowledge of human resources processes and best practices
• Strong organizational and time management skills
• Excellent verbal and written communication skills
• Ability to maintain confidentiality and handle sensitive information with discretion
• Bachelor’s or associate degree in Human Resources Management, Business or another related field (preferred)

Work Environment

• This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets, and fax machines. Essential office equipment will be provided to perform the job duties in the office and remotely.

Essential functions statement

• The person in this position will work in the office a minimum of 2 days per week. The other days can be worked either in the office or remotely.
• The person in this position frequently communicates with co-workers, subordinates, customers and vendors via phone and email. The person in this position must be able to exchange accurate information in these situations.