The Model Office Lead will be responsible for the operationalization of the target operating model for the Claims Function as part of the organization’s Claims Transformation Program
Job Summary
The Model Office Lead will be responsible for the operationalization of the target operating model for the Claims Function as part of the organization’s Claims Transformation Program.
This leadership role will establish a new operational unit that integrates adjudication, automation, validation, audit, and fraud investigation capabilities.
The Model Office Lead will shape the foundation of the organization’s next generation operating model, ensuring alignment with strategic objectives, quality standards, and regulatory expectations.
Matching Summary
The Model Office Lead will be responsible for the operationalization of the target operating model for the Claims Function as part of the organization’s Claims Transformation Program.
Skills & Requirements
Must-have
Claims Transformation Program
Claims Function operationalization
Fraud, Waste, and Abuse (FWA) management
business process transformation
high-performing and scalable operation
governance framework
performance systems
end-to-end processes
Nice-to-have
Healthier, Longer, Better Lives
culture of accountability
continuous improvement
operational discipline
diversity and inclusion
inclusive hiring practices
Key Requirements
Claims Management expertise
Fraud, Waste, and Abuse (FWA) understanding
Strong background in business process transformation
Proven leader
Experience managing shared services or outsourced environments