Sr Mgr., Claims Modernization, Reporting & Analytics - Healthfirst
Hybrid, NY
About the Job
Duties & Responsibilities:
+ Works with a team of Managers and Supervisors to establish goals, priorities and deliverables of Business/ Project Analyst team.
+ Ensures long-term strategic and short-term tactical Operational needs for process improvement and project support are agreed upon and accomplished.
+ Manages team progress and deliverables on all initiatives, consistently seeking more efficient ways to support the business using technology, cross-training, and other tools to ensure optimal performance of the Business/Project Analyst team.
+ Regularly meets with direct reports to coach, develop, and conduct monthly one-on-one meetings to drive high performance results.
+ Collaborates across impacted stakeholders to implement reporting tools that maximize efficiency and foster a high-performance culture.
+ Works with Leaders of all Operations areas to develop annual budget and quarterly budget reforecasting. Monitors monthly budget actuals against plan.
+ Gathers business requirements, develops business rules, and implements process controls.
+ Prioritizes, delegates, and monitors team workload to ensure continuous progress in being made.
+ Collaborates with Human Resources as needed to address any Personnel matters in a timely manner.
+ Remains current on reporting and database technologies and ensures Healthfirst is leveraging existing systems to maximize optimal value.
+ Collaborates with Information Technology, Business Transformation and Operations teams to support effective department management including introducing new technology, system upgrades and reporting impacts and providing leadership dashboards to assist with managing our call center business.
+ Interacts with business users and translates business needs into technology solutions to improve call handling and customer service levels.
+ Articulates conclusions and opinions in a persuasive and influential manner, with well-developed data-driven analyses or solutions that establish trust.
+ Support urgent business resumption activities related to shifting customer calls to minimize business disruption, adapting to meet business challenges.
+ Develop and implement a strategic multiyear project and resources plan, and participates in setting and executing operational plans consistent with organizational strategy.
+ Configure and manage outbound dialer campaigns
+ Supports a variety of ad-hoc report requests.
+ Attends and conducts team meetings as needed
+ Additional projects and duties as assigned.
Minimum Qualifications:
+ Experience in a supervisory/managerial role with demonstrated ability to train, mentor and manage a staff of Analysts and Project Support resources.
+ Experience leadingothers and coordinating completion of multiple tasks across all team members including telecommuters and/or staff located out of state.
+ Leadership experience within any area of operations (Member Services, Enrollment & Billing, Claims, Provider Services, etc.).
+ Experience with database reporting and automation, budgeting or internal audit processes.
+ Experience monitoring quality in a reporting and analysis environment.
+ Experience conducting root-cause analysis and making recommendations based your findings.
+ Experience with Microsoft Excel including the use of formulas, Pivot tables, and graphs to manipulate and analyze data.
+ High School Diploma OR GED from an accredited institution.
Preferred Qualifications:
+ Experience working within a Healthcare industry (such as commercial insurance plans, hospital, managed long-term care or government programs).
+ Experience working with MS Office Suite, including MS Access (reporting), MS PowerPoint (creating/editing presentations), and MS Visio (creating flow charts) and Adobe Acrobat (converting PDF files).
+ experience with data analytics and visualization tools including Alteryx, Tableau, and Tableau P
+ Ability to gather requirements, design, test and implement using agile methodologies.
+ Advanced communication skills with the ability to present to a diverse audience, including Senior Management.
+ Problem solving skills; ability to think strategically and critically in developing solutions to complex problems.
+ Strong quantitative and analytical skills.
+ Bachelors degreefrom an accredited institution.
Compliance & Regulatory Responsibilities: See Above
License/Certification: NA
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
+ Works with a team of Managers and Supervisors to establish goals, priorities and deliverables of Business/ Project Analyst team.
+ Ensures long-term strategic and short-term tactical Operational needs for process improvement and project support are agreed upon and accomplished.
+ Manages team progress and deliverables on all initiatives, consistently seeking more efficient ways to support the business using technology, cross-training, and other tools to ensure optimal performance of the Business/Project Analyst team.
+ Regularly meets with direct reports to coach, develop, and conduct monthly one-on-one meetings to drive high performance results.
+ Collaborates across impacted stakeholders to implement reporting tools that maximize efficiency and foster a high-performance culture.
+ Works with Leaders of all Operations areas to develop annual budget and quarterly budget reforecasting. Monitors monthly budget actuals against plan.
+ Gathers business requirements, develops business rules, and implements process controls.
+ Prioritizes, delegates, and monitors team workload to ensure continuous progress in being made.
+ Collaborates with Human Resources as needed to address any Personnel matters in a timely manner.
+ Remains current on reporting and database technologies and ensures Healthfirst is leveraging existing systems to maximize optimal value.
+ Collaborates with Information Technology, Business Transformation and Operations teams to support effective department management including introducing new technology, system upgrades and reporting impacts and providing leadership dashboards to assist with managing our call center business.
+ Interacts with business users and translates business needs into technology solutions to improve call handling and customer service levels.
+ Articulates conclusions and opinions in a persuasive and influential manner, with well-developed data-driven analyses or solutions that establish trust.
+ Support urgent business resumption activities related to shifting customer calls to minimize business disruption, adapting to meet business challenges.
+ Develop and implement a strategic multiyear project and resources plan, and participates in setting and executing operational plans consistent with organizational strategy.
+ Configure and manage outbound dialer campaigns
+ Supports a variety of ad-hoc report requests.
+ Attends and conducts team meetings as needed
+ Additional projects and duties as assigned.
Minimum Qualifications:
+ Experience in a supervisory/managerial role with demonstrated ability to train, mentor and manage a staff of Analysts and Project Support resources.
+ Experience leadingothers and coordinating completion of multiple tasks across all team members including telecommuters and/or staff located out of state.
+ Leadership experience within any area of operations (Member Services, Enrollment & Billing, Claims, Provider Services, etc.).
+ Experience with database reporting and automation, budgeting or internal audit processes.
+ Experience monitoring quality in a reporting and analysis environment.
+ Experience conducting root-cause analysis and making recommendations based your findings.
+ Experience with Microsoft Excel including the use of formulas, Pivot tables, and graphs to manipulate and analyze data.
+ High School Diploma OR GED from an accredited institution.
Preferred Qualifications:
+ Experience working within a Healthcare industry (such as commercial insurance plans, hospital, managed long-term care or government programs).
+ Experience working with MS Office Suite, including MS Access (reporting), MS PowerPoint (creating/editing presentations), and MS Visio (creating flow charts) and Adobe Acrobat (converting PDF files).
+ experience with data analytics and visualization tools including Alteryx, Tableau, and Tableau P
+ Ability to gather requirements, design, test and implement using agile methodologies.
+ Advanced communication skills with the ability to present to a diverse audience, including Senior Management.
+ Problem solving skills; ability to think strategically and critically in developing solutions to complex problems.
+ Strong quantitative and analytical skills.
+ Bachelors degreefrom an accredited institution.
Compliance & Regulatory Responsibilities: See Above
License/Certification: NA
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
Source : Healthfirst
