Benefit Management System Contract Manager

Cheyenne, WY - USA

Monthly Salary: Not Disclosed

Posted on: Yesterday

Vacancies: 1 Vacancy

Job Summary

Description and Functions

Open Until Filled

GENERAL DESCRIPTION:

This position manages and oversees benefit and provider management systems for Wyomings statewide Medicaid program including oversight of the vendors and systems that conduct reimbursement expenditure management and communication for programs that comprehensively pay over $500 million annually. This position directly manages the Benefits Management System (BMS) contract to provide vendor oversight and performance monitoring to ensure accurate appropriate and efficient processing of over three million claims per year for Medicaid clients and enrolled providers and a large array of other mission-critical functions.

Working for the State of Wyoming offers more than a paycheck. Our total compensation package includes:

Comprehensive health dental and vision insurance
Paid vacation sick leave FMLA and holidays
Retirement - Pension and 457B plans that help you build a secure future
Flexible schedules and work-life balance options
Meaningful work that makes a difference for Wyoming communities

and MUCH MORE!Click here for detailed information or you can watch this short video to learn about our benefit package!

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Human Resource Contact:

ESSENTIAL FUNCTIONS: The listed functions are illustrative only and are not intended to describe every function that may be performed in the job level.

Independently directs and oversees the Benefits Management System (BMS) contract and system that processes benefit payments of over $ ($1 billion) per biennium.
Collaborate with business owners and policy groups throughout Medicaid and CHIP to support their business needs.
Directs approves and oversees the internal system changes requests for operation benefit payment processing and federal mandate requirements.
Maintains statistical reporting standards for the Medicaid program and monitors benefit and provider-related reporting.
Accounting code determination and financial reporting for the benefit payment processing functions.
Management and direction of system security for the Division of Healthcare Financing and other programs related to Medicaid payments.
Coordination and management of the state-wide annual IT audit and federal audits related to the systems this position oversees.
Process invoices and other contract materials.
Manage a system vendor budget of $8 million to $10 million annually. Manage other contracts related to operating the systems such as additional licensing or services.

Qualifications

PREFERENCES:

Preference will be given to candidates with:

Bachelors degree or equivalent experience and training typically in business policy planning information technology public administration healthcare administration or other closely related fields.
Minimum of five years of professional work experience in business accounting healthcare administration insurance or public administration.
Five years of experience in managing a budget reporting and IT project experience.
Minimum of three years supervising programs and/or systems.
Demonstrated ability to balance multiple demands on time and resources when assigning projects or delegating responsibilities to team members. This includes interpersonal relations team building consensus building goal setting and team motivation.
Demonstrated ability to research and analyze complex problems and identify options and solutions; decision-making and evaluation of results. Demonstrated skill in public speaking and oral and written communication at a variety of levels and with multiple audiences.

KNOWLEDGE:

Understand how the Benefit Management System (BMS) interacts and interfaces with other Medicaid Federal and non-Medicaid systems.
State government functions and procedures including State and federal laws policies and procedures.
Medicaid law and regulatory structure including State and federal Medicaid statutes regulations and policies.
Knowledge of accounting budgeting and data analysis.
Concepts principles and practices of professional healthcare administration; challenges and trends in healthcare and service provision.
Development negotiation and administration of large-scale contracts and budget determination for federal funding sources.
Contract procurement negotiation and administration.
Accounting and budgeting in the Wyoming government.
Information Technology (IT) knowledge of Medicaid systems and operations. Change order management. User Acceptance Testing coordination and direct testing of defects and changes.
Project management knowledge to plan and coordinate large enhancements or operational changes.

MINIMUM QUALIFICATIONS:

Education:

Bachelors Degree (typically in Healthcare)

Experience:

2-4 years of progressive work experience (typically in Health Programs) with acquired knowledge at the level of a Health Program Manager I

Education & ExperienceSubstitution:

5-7 years of progressive work experience (typically in Health Programs) with acquired knowledge at the level of a Health Program Manager I

Certificates Licenses Registrations:

None

Necessary Special Requirements

PHYSICAL WORKING CONDITIONS:

The employee may sit comfortably to perform the work; however there may be some walking standing bending carrying light items driving an automobile etc.

NOTES:

FLSA: Exempt
The Wyoming Department of Health is anE-Verify employer.

Supplemental Information

Clickhereto view the State of Wyoming Total Compensation Calculator.

Click here to view the State of Wyoming Classification and Pay Structure.

URL: State of Wyoming is an Equal Opportunity Employer and actively supports the ADA and reasonably accommodates qualified applicants with disabilities.

Class Specifications are subject to change please refer to the A & I HRD Website to ensure that you have the most recent version.

Required Experience:

Manager

Description and FunctionsOpen Until FilledGENERAL DESCRIPTION: This position manages and oversees benefit and provider management systems for Wyomings statewide Medicaid program including oversight of the vendors and systems that conduct reimbursement expenditure management and communication for pro...