Manager Medicaid Encounters

Hcsc Richardson , TX 75080

Posted 3 months ago

Job ID: DLP-1034498

Description:

Job Purpose:

This position is responsible for leading HCSC's Illinois Medicaid encounter reporting activities and functions. Operational areas of responsibility include encounter data management, submissions; reject remediation, vendor management, as well as, interfacing with state regulatory agencies. This individual must be experienced in managing day to day Medicaid encounter operations and submissions.

Job Responsibilities:

  • Oversees encounter data collection, processing, submission and data reconciliation efforts ensuring that collected data is processed and submitted according to State guidelines and requirements.

  • Directs the operations of encounter data aggregation processing and submission by coordinating and overseeing staff prioritizing tasks and resolving issues as they occur.

  • Analyze encounter data to identify trends, and conduct root cause analysis; develop improvement plans, organize cross-functional teams and develop high-quality output for internal and external constituents to address identified issues

  • Oversees encounter data vendor relationships by monitoring their performance and guiding them through issues and priorities

  • Develop and execute action plans to respond to new encounter regulatory requirements

  • Leads staff assigned to Medicaid encounter reporting, provides guidance and engagement of staff; and builds effective teams (both internally and with vendors) to achieve established goals.

  • Maintains expert knowledge of IL Medicaid encounter reporting requirements, including regulatory changes impacting the program

  • Serves as a Subject Matter Expert for other department, providers and committees

  • Build and maintain relationships with leadership at all levels to build credibility and crucial support for the business' process, methodologies and technologies

  • Performs any other job-related duties as assigned.

Required Job Qualifications:

  • Bachelors or Advanced degree in Business Administration, Finance, Statistics, Healthcare Administration and minimum of 6 years of experience in Medicaid managed care

  • Experience with IL Medicaid encounter management ,reporting and requirements

  • Knowledge of Medicaid Encounter Data System & understanding of 837 I & P file formats

  • Experience in Vendor management, SLA enforcements, negotiations

  • Ability to create presentations & exhibits for executives

  • Strong interpersonal, organizational and workflow skills

  • Willingness and ability to travel 25

Preferred Job Qualifications:

  • Experience with encounter file preparation and remediation.

  • Experience with databases as well interpretation and manipulation of related data.

  • Knowledge of other managed care products including Commercial Exchange and Medicare Advantage, TX Medicaid

  • CA

HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

Requirements:

Expertise Other, Government Programs Job Type Full-Time Regular Location TX - Richardson, IL - Chicago


icon no score

See how you match
to the job

Find your dream job anywhere
with the LiveCareer app.
Mobile App Icon
Download the
LiveCareer app and find
your dream job anywhere
App Store Icon Google Play Icon
lc_ad

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Lead Medicaid Marketing Communication Consultant

Hcsc

Posted 2 weeks ago

VIEW JOBS 10/8/2019 12:00:00 AM 2020-01-06T00:00 Job ID: TR-1035787 Description: Lead Medicaid Marketing Communications Consultant BASIC FUNCTION: (INTEGRATED MARKETING):This position is responsible for leading the strategic development and overseeing the creation of targeted, account-specific or line of business (Medicare, Medicaid) communication plans, including the development of materials that are contractually required and/or supportive of member enrollment and onboarding; managing high level departmental or division projects and representing the manager and/or the department on committees and special task forces; overseeing work of other department writers on projects and managing vendor relationships; developing, monitoring, and evaluating budget for literature under his/her purview; and working with other staff on budget projections. JOB REQUIREMENTS: * Bachelor Degree or 4 years marketing, journalism or communications experience. * 7 years of experience in communications environment. * Experience with Medicaid products for developing marketing materials supporting Medicaid products * Knowledge of design, layout, and print production. * Project management skills. * Writing and verbal communications and editing skills. * Independent, self-starter, ability to handle multiple projects simultaneously. PREFERRED JOB REQUIREMENTS: * Bachelor Degree in Journalism or Communications. * Experience in an agency environment creating marketing communications campaigns and materials for Medicaid products and programs HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. Requirements: Expertise Communications Job Type Full-Time Regular Location TX - Dallas, TX - Richardson, IL - Chicago Hcsc Richardson TX

Manager Medicaid Encounters

Hcsc