Manager Reimbursement Systems Configuration (Telecommute)
Manager Reimbursement Systems Configuration (Telecommute)
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Job Description
Were hunting for a Manager of Reimbursement Systems Configuration (telecommuter/remote) someone whos ready to be part of the best ranked childrens hospital in Texas and among the best in the this position you 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
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
