Location: Idlewild Ave, Tampa, FL 33634
Department: Operations - Encounters
Manages a team that reviews state and CMS encounter regulations and addresses gaps and issues associated with end to end claims payment and encounter processes. Manages and coordinates, along with our IT and state partners, the execution and fulfillment of our encounter reporting for various states. Oversees performance results of the Encounters department.
- Leads and implements changes in our processes in order to fulfill our encounter submission requirements.
- Implements initiatives by managing a detailed action plan, coordinating action steps with cross functional partners, driving resolution of implementation related issues and education of cross functional partners.
- Serves as a single point of contact for all encounters related issues specific to a project.
- Supervises trains, evaluates and develops direct reports who include Managers and/or Analysts.
- Manages internal reporting requirements for dashboards and team metrics.
- Manages process improvement initiatives, seeking root cause and developing appropriate corrective action.
- Establishes objectives, goals and performance measures for the function being managed.
- Coordinates activities to ensure key deliverables are met and resolves conflicting demands.
- Applies a comprehensive knowledge of provider data management to the completion of assignments. Has an understanding of provider contracts and configuration within ours systems.
- Serves as primary contact to our state partners for complex encounter issues.
- Develops successful working relations with key functional areas (i.e. IT, State leadership, Configuration, and Medical Economics etc).
- Assists in developing both short and long range plans for overall departmental activities.
- Oversees the implementation of programs and strategies.
- Assists in determining recommendations on matters of policy, and approves changes in area of expertise
- Required: Bachelor's Degree in a related field; or equivalent experience
- Required: 7 years of experience in environments with large, complex, real-time transaction volumes, analyzing and defining solutions to complex business and technical issues
- Required: 5 years of management experience; or equivalent combination of management and leading large scale projects or business process improvement initiatives
- Required: Experience with one or more of the following: large data sets, work flow tools, SQL, SAS and/or Tableau
- Preferred: 7 years of experience in Healthcare
- Demonstrated leadership skills
- Demonstrated written communication skills
- Demonstrated interpersonal/verbal communication skills
- Demonstrated Facilitative skills
- Ability to drive multiple projects
- Demonstrated negotiation skills