Imagine a workplace that encourages you to interpret, innovate and inspire. Our employees do just that by helping healthcare payers manage the cost of care, improve competitiveness and inspire positive change. You can be part of an established company with a 40-year legacy that helps our customers thrive by interpreting our client's needs and tailoring innovative healthcare cost management solutions.
Our commitment to diversity, inclusion and belonging are part of the fabric of our company. We strive to create a workplace that fosters mutual respect and collaboration, where every talented individual can participate and perform their best work. We are MultiPlan and we are where bright people come to shine!
JOB DESCRIPTION
This position is responsible for managing clients' implementation of Medicare Advantage network products. Work to ensure development of efficient product solutions that meet customer expectations and needs. The incumbent manages, develops, and maintains reporting and analytics process for the operations team that fully support and maintain department standards and procedures.
Partner with senior manager to develop and drive key initiatives and projects falling under department purview.
Establish, guide and champion efficient processes specific to product development in relation to department owned and utilized programs and procedures.
Develop and maintain subject matter expertise applicable to multiple operational areas and department owned and utilized systems. As system owner, provide direction, support and cross-training as appropriate to ensure smooth, efficient operations.
Serve as a key team member and department representative/decision maker throughout product development processes.
Manage and coordinate reporting processes specific to non-respondent population for all lines of business to ensure inclusion of government products. Develop, and maintain expert level knowledge of utilized reports and ensure efficient communication to appropriate individuals and departments as appropriate.
Partner with tactical teams to manage, deliver, and maintain software solutions that support project defined strategies and initiatives.
Build and maintain strong cross-functional relationships to ensure customer expectations and standards are continuously met and ensure project success.
Partner with business stakeholders to actively solicit, analyze and negotiate customer requirements. Obtain signoff on business requirements.
Develop, implement, and maintain solutions specific to operational reporting and analytics. Ensure solutions provided properly support initiatives and standards defined by Credentialing and Provider Data Management (PDM) operations teams.
Select, develop, and evaluate staff to ensure the efficient team operations.
Collaborate, coordinate, and communicate across disciplines and departments.
Ensure compliance with HIPAA regulations and requirements.
Demonstrate Company's Competencies and Core values held within.
The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.
JOB SCOPE:
This position works independently with minimal supervision to complete the job responsibilities. Work is often varied and complex, and may require the use of a broad knowledge base gained through experience. The incumbent uses knowledge of the Company's general business principles, industry dynamics, market trends, and specific operational details when performing all aspects of the positions. The incumbent may have regular contact with all levels of internal and external sources to complete position objectives, keeping the needs of external and internal customers as a priority when making decisions and taking action. This is a people management position with moderate authority for all HR actions (hiring, separations, discipline, training, etc.)
Requirements
REQUIREMENTS
HS Diploma and 5 years of related experience; Bachelor's degree strongly preferred.
Minimum 3 years of experience as an operational subject matter expert or area manager in related managed healthcare environment including minimum 1 year of project management and supervisory experience
Responsible for managing clients' implementation of Medicare Advantage network products
Technical experience/background to include but not limited to developing access databases
Experience understanding and managing within prescribed project management methodologies, and requirements definition and management practices
Knowledge of Medicare Advantage
Knowledge of accreditation standards related to NCQA and state regulatory agencies
Knowledge of the Company's data systems and a familiarity with Imaging/Workflow Environment; ECHO database systems; Provider Data Management processes (Registrar, Cred/ReCred, Demographics, rates) and Service Operations desirable.
Knowledge of departmental processes and its relationship with organizational objectives and outcomes.
Communication (oral, written and listening), prioritization, organizational, project and process management, leadership, technical, analytical, reporting and team building skills
Ability to lead, motivate and mentor individuals and teams
Ability to negotiate and coordinate activities of individuals and groups
Ability to effectively manage resources and workflow for multiple projects simultaneously
Ability to use software, hardware and peripherals related to job responsibilities including MS Office
Ability to manage operations in a high volume, date driven environment
Ability to translate business vision and strategy into project requirements
Ability to work with and understand complex data systems
Ability to keep the needs of external and internal customers a priority when making decisions and taking action
Ability to focus on results and successful achievement of business objectives
Ability to collaborate with others to ensure best practices are explored, implemented and shared
Ability to develop and maintain cooperative relationships at all organizational levels.
Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone
BENEFITS
We realize that our employees are instrumental to our success, and we reward them accordingly with very competitive compensation and benefits packages, an incentive bonus program, as well as recognition and awards programs. Our work environment is friendly and supportive, and we offer flexible schedules whenever possible, as well as a wide range of live and web-based professional development and educational programs to prepare you for advancement opportunities.
Your benefits will include:
Medical, dental, and vision coverage (low copay & deductible)
