• Manages the daytoday activity of the patient financial assistance programs which includes responding to inquiries educating staff collaborating with stakeholders preparing reports and attending meetings
• Develops workflows and job aids i.e. resource list telephone list process criteria policy related information
• Collaborates and communications with other departments on related projects and inter departmental operations issues
• Documents workflows and policy and procedures
• Reviews public health data analyzing statewide trends and health information from public and private sources to arrive at a description of the population from the perspective of size; age and sex; disease burden; utilization patterns preventive service use and medication experience
• Completes operational and financial analysis for review
• Collaborates with all stakeholders to identify opportunities to improve quality and control cost. Creates a plan and measures the impact of the agreed upon interventions
• Provides training and job aids for staff who are supporting the patient financial assistances programs
• Develops processes and protocols to develop core competencies of an effective organization managing care utilized by financial assistance program members such as understanding and mitigating risk member outreach care coordination financial and utilization review and network management
• Leverages CCH technology and to best serve patients i.e. portal access eConsult etc.
• Prepares and submits management and regulatory reports including dashboard for senior leadership as required
• Performs other duties as needed

Minimum Qualifications

• Associates degree from an accredited college or university with five 5 of experience managing a team with Medicare Medicaid and/or Commercial insurance products OR Bachelors degree from an accredited college or university with three 3 years of experience managing a team with Medicare Medicaid and/or Commercial insurance products
• Two 2 years of work experience interfacing with diverse stakeholders i.e. community advocates physicians and community members
• One 1 year work experience in analyzing financial and administrative data
• Intermediate knowledge of Microsoft (Word Excel Access PowerPoint Outlook)

Preferred Qualifications

• Bachelors degree in Business Healthcare Administration or Public Health from an accredited college or university
• Bilingual
• Experience and advanced knowledge of contractual administrative health insurance and operational issues related to managed care organizations physician groups hospitals and health insurance benefit plan designs
• Previous experience with databases and contract modeling

Knowledge Skills Abilities and Other Characteristics

• Knowledge of the Illinois Managed Care Model including IPAs Medical Groups MSOs Health Systems and Health Plans DOFR Medicare and Commercial Fee Schedules.
• Knowledge and understanding of contracting including financial analysis credentialing legal review implementation preferred CAP Valuebase and utilization data.
• Knowledge of network management including grievance resolution authorizations and resolving complex memberlevel issues.
• Excellent communication presentation and negotiation skills.
• Ability to work with and influence others including customer service revenue cycle staff and key strategic partners.
• Ability to planning design development implementation and evaluate policies and procedures.
• Ability to prioritize work and ensure all compliance elements are met aligns program operations to governmental sponsored programs.
• Ability to maintain confidentiality of all patient information as per HIPAA guidelines.
• Ability to maintain or exceeds all standards as per the approved Plan accreditation bodies.
• Ability to maintain a full comprehensive understanding of the covered benefits coding and reimbursement policies and contracts.
• Ability to develop a network that supports program objectives.
• Ability to work collaboratively to achieve project goals.

• Competitive Salary
• Paid Time Off
• Health Vision & Dental Insurance
• Health Savings Account (HSA)
• Flexible Spending Account (FSA)
• Short & LongTerm Disability
• 401(K)
• Life Insurance