About this opportunity
Sky Mavis lists this Configuration Manager opportunity in henderson, Nevada. Review the employer’s description below for duties, qualifications and application requirements.
Job description
Overall Purpose
The main functions of this position are responsible for leading, coaching and guiding staff that implement, support, and maintain the core administrative system configuration including but not limited to: EDI transactions, provider, health plan benefits and member eligibility data, encounters submissions and reconciliations, CMS/health plan claim reporting, internal claim reporting and data entry. This role will be responsible for continuing to enhance the vision, value proposition, services for the configuration function and develop and align the staff in place to deliver against these services.
Essential Functions
Coordinate and supervise daily/weekly/monthly activities of a team members including setting priorities for the team to ensure task completion and performance goals are met
Respond configuration escalations
Provide coaching, feedback, and annual performance reviews as well as formal corrective action
Manage inventory and performance to business metrics
Write and Submit P&P update requests
Provide expertise or general system configuration support to team in reviewing, researching, investigating, system configuration
Support team employee engagement
Communicate and collaborate with internal and external business partners
Document and communicate status of system configuration to stakeholders as needed
Achieve applicable performance metrics (productivity, quality, TAT, utilization)
Advanced problem solving, critical thinking, and process analysis skills to lead teams responsible for client configuration
Understanding of the healthcare industry, including competitors, the regulatory environment, and industry trends
Ability to provide strategic leadership and demonstrate the ability to develop future-state scenarios, create a vision for the future, defines factors needed to achieve success, and key actions required.
Demonstrated leadership skills having lead configuration activity or function, knowledgeable about configuration best practices, methodologies and tools
Other tasks assigned by manager
Knowledge, Skills and Abilities
Must have a strong understanding of any local, state and federal rules regarding the adjudication of medical benefits
Strong organizational and time management skills with the ability to prioritize individual workloads.
Proficient in MS Office with strong computer skills (e.g. multiple systems experiences, keyboarding skills, Microsoft word, Power Point)
Strong knowledge of CPT, HCPCS, ICD-10, DRG and APC coding and CMS Guidelines.
Ability to drive performance management
Ability to interpret electronic data interchange preferred
Knowledge of CMS EDI file and submission protocols
Knowledge of CMS claim reporting: ODAG and Part C
Experience
+ 6 years health care administration operational experience
5 years of health care operations and health care system configuration knowledge
Experience managing at least six direct reports
Extensive experience in plan building, provider data maintenance and reimbursement methodologies including fee schedules, contract management and workflow processes.
Experience analyzing and identifying trends preferred
Education
High school diploma or GED required
Bachelor’s degree preferred
Work Location & Schedule
This role offers a hybrid work arrangement. Candidates will follow our hybrid schedule, working in office three days per week.
Pay range: $100,000-135,000 depending on experience
About P3
People. Passion. Purpose.
At P3 Health Partners, our promise is to guide our communities to better health, unburden clinicians, align incentives and engage patients. We are a physician-led organization relentless in our mission to overcome all obstacles by positively disrupting the business of health care, transforming it from sickness care into wellness guidance. If you are passionate about your work; eager to have fun; and motivated to be part of a fast-growing organization, then you should consider joining our team.
#J-18808-Ljbffr
Worksite address
henderson, NV, 89077, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.