Manager, Reimbursement Systems Configuration
Manager, Reimbursement Systems Configuration
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Job Description
Were hunting for a Manager of Reimbursement Systems Configuration someone whos ready to be part of the best ranked childrens hospital in Texas and among the best in the nation. In this position you will will be responsible the for the day-to-day Operations of a Production driven team(s) maintaining State and Regulatory requirements along with departmental SLAs. Establishes implements and monitors quality control measures. Develops tracks and reports performance productivity metrics proactively identifying trends and refocusing the direction of the team(s). Independently accesses workflows and processes for potential improvements and efficiencies. Works collaboratively with leadership and others from various areas across the health plan to evaluate and work cross functionally to implement new ideas and new strategies.
Think youve got what it takes
Job Duties & Responsibilities
- Manages Business Operations Team
- Manage the work and the direction of the team
- Direct the Department standards to meet and then exceed any State Requirements
- Manages cross function work groups to create and implement best practices across multiple Departments
- Report out to Leadership and Executive Leadership with quantifiable metrics on the quality of the data
- Define the Department scope and review and sign off on policies and procedures
- Educate other departments on provider data use in all systems
- Establishes implements and monitors quality control measures related to process and/or system changes impacting reimbursement & benefits
- Applies regulatory and systems knowledge to ensure regulatory adherence for provider reimbursement
- Applies reimbursement regulatory payment integrity and systems functional knowledge to ensure regulatory adherence for provider reimbursement Accountability C: Business strategy reporting and communication
- Quality Management
- Coaching and developing
Skills & Requirements
- Bachelors Degree required
- Other Medical Coding Certificate preferred
- 5 years Project management experience required
- 3 years Management/Leadership experience required
- 3 years Healthcare industry or MCO environment required
- Four (4) years configuration payment integrity reimbursement experience can substitute a bachelors degree
Required Experience:
Manager
Employment Type
Full-Time
