• Designs, builds and maintains operational processes, policies and procedures to support Claims processing. • Partners with IT and other leaders to develop business requirements to support core administration system deployment. • Recruits, trains and develops a highly engaged team of claims processors. • Claims inventory management and load balancing to meet contractual and organizational objectives. • Anticipates future demands of initiatives related to people, process and technology and works with leadership to design and implement solutions to these needs. • Collaborates with IT, Enrollment, Medical Management, Member & Provider Services and Finance to identify and implement processes to drive continuous improvement. • Continually assesses activities and processes to ensure efficiency and added value.