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We are currently seeking a talented Business Process Owner I that will support Medicare Supplement Claims for USAA Life Company Claims Operations.   This employee will report to the Life Company Chief Claims & Fraud Officer and will work on Medicare Supplement Claims activities and ensure a flawless execution of business-related processes, procedures, oversight and execution of the end-to-end claims process.  This role will work with our third-party supplier and key business partners supporting our Medicare Supplement Claims.  As business process owner, the employee will lead planning for complex processes including problem definition, evaluation of requirements, design, testing and implementation of business processes. This role will involve execution of any Issue Management matters for Medicare Supplement claim issues.

As business process owner, plans, directs and coordinates activities for moderately complex and complex processes, including problem definition, evaluation of requirements, design, testing, and implementation of business processes. Understands the process operating objectives, business rules, performance requirements, risks, and controls and interactions between dependent processes to minimize failures, eliminate redundancies, and control process performance necessary to achieve efficient, effective design and execution of the process. Supports alignment of process to overall experience strategy and vision.

We offer a flexible work environment that requires an individual to be in the office 4 days per week. This position will be based in San Antonio, TX; Phoenix, AZ; Colorado Springs, CO. or Tampa, FL.   Relocation assistance is not available for this position.

Job Description

What you'll do:

• Applies knowledge of the business to understand customer gaps in performance, and develops, modifies, re-engineers customer specific process program plans in alignment with business deliverables and enterprise strategy to achieve the level of desired performance. 

• Participates in the implementation of customer engagement and product development plans as functional expert bringing diverse perspective to leverage multiple ways of thinking while developing end-user focused process solutions.

• Plans and coordinates the overall health of processes by developing control limits, monitoring key performance indicators, etc.  

• Assists in business process risk management by using established methodologies and exercising control plans to ensure alignment with business unit specific requirements, process requirements, and business needs.

• Assists in identification of business unit and business process risks across assigned activities.

• Develops communication plans for customers and internal stakeholders. 

• Ensures alignment between internal stakeholders and customers across assigned business process projects and services using proactive communication and engagement strategies.

• Utilizes reporting, data, and analytics to measure process and project performance, adjust services and operational activities, and inform key stakeholders.

• Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.

What you have:

• Bachelor’s degree OR 4 years of related experience (in addition to the minimum years of experience required) may be substituted in lieu of degree.  (Total of 8 years without bachelor’s degree)

• 4 years business process execution/knowledge/experience, consulting, and/or process engineering/optimization.

• Experience in successfully applying quality management, process improvement, and problem-solving tools and methodologies.

• Hands on experience with process mapping and modeling, and creating and validating process documentation.

• Understanding and application of process management standards and policies, and knowledge of applicable regulations and risk management practices. 

• Demonstrated experience with utilizing various systems to collect and analyze data.

What sets you apart:

• US military experience through military service or a military spouse/domestic partner

• 5 or more years of Medicare Supplement claims and/or Medicare Claims knowledge and experience

• 5 or more years of experience working with Medicare Supplement and Medicare product management.

• Knowledge of Medicare State and Federal Regulations

• Knowledge of Medicare coding, billing, and allowed and denied services.

• Knowledge of negotiated Medicare Exhausted claims, and other categories of Medicare claim settlements

• Knowledge of process, procedures and requirements related to Centers for Medicare & Medicare Services (CMS)

•  Extensive experience working health claims and/or health insurance products with an insurance company.

The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job.

What we offer:

Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location. The salary range for this position is: $74,210 - $137,700.

Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.

Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning, and continuing education assists employees with their professional goals.

For more details on our outstanding benefits, please visit our benefits page on USAAjobs.com.

Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting.

USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.