Job: Medicare Manager - Business Aps & Analysis

This posting has expired and is no longer available on Jobing.com.

Browse Similar Jobs: Management - Mid-Level (Manager, Director)

Jobing Description

Category: Leadership/Management
Facility: Phoenix Health Plan/Abrazo Advantage Health Plan
Department: Business Aps & Analysis
Schedule: Full Time
Shift: Day Shift
Hours: 80
Job Details:Overview: This person requires minimal supervision and may be involved in training and mentoring staff. Works directly with end users to develop or modify applications and functions to meet user needs. Position evaluates customer system needs, implements solutions to complex problems and communicates with customers throughout the process, coordinating new projects of a complex nature, and communicating effectively to insure delivery of quality products to the customer. Works closely with vendors and regulators to evaluate the most appropriate use of systems and products. Position provides appropriate application documentation and workflow, communicates effectively with customers and vendors, educates customers using terminology they understand, assesses and identifies system needs and customer needs, interacts effectively as a member of a team, plans and organizes tasks/projects so tasks/projects are delivered on time. This person manages multiple priorities, meets deadlines, participates in group meetings, and uses departmental procedures and project management methodologies to create efficiencies.

This person supports Abrazo Advantage Health Plan and Phoenix Health Plans data needs, report development, design and data analysis. This person works with complex projects that may require thoughtful preparation, design, analysis, testing and implementation of the system changes to meet the needs of the health plan and its operations. This person is responsible for designing and maintaining complex databases and SQL scripts. Primary duties include:
Read regulations, chapters, and notifications from CMS regarding the Medicare Program and evaluate the information to identify the necessary system changes. Perform system updates in accordance with regulatory mandates and/or health plan contract changes. Ensure mandated reporting or database needs are produced, submitted and communicated timely.
Perform data exchanges within the timelines and submission windows as required by regulatory agency (CMS).
Work directly with end users to evaluate customer system or reporting needs. Develop or modify applications and implement solutions to complex reporting problems. Manage multiple tasks to simultaneously accomplish projects and timelines. Readjust priorities as business needs change. Communicate with Director and end users to develop/identify project timelines for assigned projects and manage to those timelines while producing high quality results.
Analyze, design, develop, test and implement reports, databases, spreadsheets or scripts to meet the data/information needs of the Health Plan.
Work with BAA Director, Medicare Director, Compliance Officer, or Project Managers to deliver the system and reporting needs as a result of the regulatory changes/projects. Meet timelines as assigned by the BAA Director or Project Managers or negotiate agreed upon timelines. Update the status of tasks on a regular basis.
Plan and organize work. Consistently meet deadlines across a variety of separate tasks. Anticipate and adjust for problems or barriers. Troubleshoot activities related to system software or hardware impacting the health plans data needs. Review Production Scheduled Reports/Models that failed and determine next steps. Communicate with users the availability of the data/information.
Assist in coordinating or facilitating testing activities related to the health plans data needs. Provide education and training to allow users and other team members to understand the data results and/or retrieve regular reports with the tools available or educate others to run their own reports.
Maintain strong working knowledge of software support systems utilized within the organization. Act as a liaison with Information Technology and other contracted IT and technology vendors to evaluate the most appropriate use of systems and products.
Respond appropriately to issues without access to complete information. Provide momentum. Work with others to get things done most efficiently. Embrace hard work and consistently seek out new challenges. Proactively uncover and utilize opportunities.
Deliver high quality customer service. Use a variety of resources to anticipate the needs and requirements of customers. Recognize emerging trends in customer needs and expectations. Deliver outstanding performance exceeding customer expectations and follow through to ensure customer satisfaction. Show commitment to continuous improvement. Maintain attitude of total commitment to customer needs and issues. Gain the trust and respect of customers through established and effective long-term relationships.
Document Report Criteria and complex scripts and/or SQL Queries and maintain the Reports Matrix.
Assist with CMS audits.

Special Skills: Must have outstanding leadership skills and the ability to motivate other team members. Is customer service oriented, approachable and a good listener. Is a change agent able to develop, implement, and maintain systems, policies and processes. Is a creative, independent thinker and exercises solid judgment. Has experience developing, monitoring, and controlling processes and policies within the areas of responsibility. Possesses solid analytical and problem-solving skills along with the ability to utilize the appropriate management techniques to plan, organize, control, and coordinate activities. Has strong health plan business knowledge experience. Has experience successfully implementing multiple complex projects simultaneously using project management methodologies. Must have the ability to review and analyze CMS memos and documentation to identify impacts to the health plan systems.

Minimum Requirements: Associate degree with emphasis on computer software or high school diploma with 5 years experience in IT or health plan systems development and support required. Minimum of five (5) years Information Technology and Project Management experience. Strong aptitude for learning and using software programs. High level of expertise in multiple hardware platforms and computer software; proficiency in Microsoft Office products (including Access), Crystal Reports, and SQL. Strong attention to detail with excellent oral and written communication skills. Minimum 3 years experience in healthcare systems with extensive experience with reporting and reporting tools.Experience with Medicare.
Preferred Qualifications: BS in Healthcare or Compuuter Science or equivalent preferred. Prefer five (5) years experience in health care and experience with product development (requirements, analysis, design) and system support including development of workflow, test plans and quality assurance. Experience includes development of databases using MSAccess or SQL and development of reports using MSExcel, MSAccess and Crystal Reports or Oracle. Experience with management of medium to large size software development and/or implementation projects. Prefer someone with extensive knowledge of Medicare.

~IND

Skills / Requirements

See Above