Director of TPA- PRxN

Under the direction of the Executive Director of PRxN Finance and Operations, the incumbent operationally oversees the day to day management of the Third Party Administration Division within PRxN. The Director provides leadership to TPA staff ensuring division optimally executes eligibility management, claims adjudication, provider payments and utilization reporting functions in order to achieve client retention and customer satisfaction. BS/BA required; MA in Business Administration, Public Administration or Healthcare preferred; minimum of ten (10) years experience in healthcare industry preferred; minimum of five (5) years experience supervising or managing staff preferred. Familiarity with RIMS QicLink claims processing system or some other medical claims processing system, EDI/Imaging System and claims repricing is preferred.

The Mashantucket Pequot Tribe practices Indian preference in hiring and is an Equal Opportunity Employer. (MPTN Indian Preference Policy, MPTN Equal Employment Opportunity Policy)