Knowledge Manager, Enrollment & Billing - Emblem Health

• Oversight for Medicaid related billing & reconciliation processes that include kick payments and stop loss.
• Proactively drive Enrollment and Billing operations vendor knowledge management performance to achieve contractual targets.
• Frequently interface with knowledge management counterparts of vendors to continuously improve policies, procedure, training material and other resources for all Enrollment, Billing and Premium related activities to ensure an end-to-end approach and favorable results across the Enterprise.
• Direct continuous quality improvement.

• Ensures timely reconciliation and follow up with state related agencies and other stakeholders.
• Drive knowledge management performance of Operations vendors for each core process to meet contractual requirements and align with our enterprise customer experience objectives. Direct and manage Operations vendor knowledge management counterparts by conducting reviews and training, transactional audits, policy, procedure and knowledge management program verifications and compliance reviews. Engage knowledge management counterparts via weekly huddles, transactional procedure reviews, corrective actions relating to incomplete or inaccurate information and formal Tollgate reviews.
• Develop all policies for respective Tower and cascade information to all Operations vendors as required to align knowledge. Align Operations vendor policies and procedures with internal policy documentation as required.
• Work cross-functionally to plan, organize, design, develop, communicate and implement best practice processes across the enterprise
• Review and evaluate the effectiveness of training-related initiatives based upon business results, internal feedback and/or quantitative measures such as training evaluations or knowledge/skill "tests".
• Communicate and collaborate with internal stakeholders (including but not limited to Marketing and Communications, Product Management, Network and Medical Management, Compliance and Quality Management) as needed to support overall Enterprise quality and customer experience objectives. Be proactive and clear (useExecutive Briefing Tool) when communicating milestones and status and selling ideas and proposals.
• Contribute as a subject matter expert to strategic initiatives.
• Ensure timely follow up and create a proactive vs reactive environment to demonstrate confidence and partner collaboration.

Qualifications:

• Bachelor's Degree required; additional years of experience and/or training/certifications may be considered in lieu of educational requirements
• 5-8 years of relevant experience in Knowledge Management and Improvement, Change Management, and Customer Experience required
• Energy, drive and passion for End-to-End excellence and customer experience improvement required
• Excellent collaboration skills and the ability to influence management decisions required
• Strong problem solving and analytical skills that be applied across all types of business problems required
• Strong facilitation, oral and written communication and presentation skills required
• Proficiency in Microsoft Office suite, including advanced Excel skills and MS Access required
• Solid coaching and mentoring skills to continuously develop staff core competencies at vendors required

Additional Information

• Requisition ID: 1000000667
• Hiring Range: $90,000-$110,000