Texas Children's Careers

Compensation

Full Description

We’re hunting for a Manager of Reimbursement Systems Configuration (telecommuter/remote), someone who’s ready to be part of the best ranked children’s hospital in Texas, and among the best in the nation. In this position, you will be responsible the for the day-to-day Operations of a Production driven team(s), maintaining State and Regulatory requirements along with departmental SLAs. Establishes, implements, and monitors quality control measures. Develops, tracks and reports performance, productivity metrics, proactively identifying trends and refocusing the direction of the team(s). Independently accesses workflows and processes for potential improvements and efficiencies. Works collaboratively with leadership and others from various areas across the health plan to evaluate and work cross functionally to implement new ideas and new strategies. Think you’ve got what it takes? Job Duties & Responsibilities Manages Business Operations Team Manage the work and the direction of the team Direct the Department standards to meet and then exceed any State Requirements Manages cross function work groups to create and implement best practices across multiple Departments Report out to Leadership and Executive Leadership with quantifiable metrics on the quality of the data Define the Department scope and review and sign off on policies and procedures Educate other departments on provider data use in all systems Establishes, implements, and monitors quality control measures related to process and/or system changes impacting reimbursement & benefits Applies regulatory and systems knowledge to ensure regulatory adherence for provider reimbursement Applies reimbursement, regulatory, payment integrity, and systems functional knowledge to ensure regulatory adherence for provider reimbursement Quality Management Coaching and developing Skills & Requirements Bachelor's Degree required Other Medical Coding Certificate preferred 5 years Project management experience required 3 years Management/Leadership experience required 3 years Healthcare industry or MCO environment required Four (4) years configuration, payment integrity, reimbursement experience can substitute a bachelor's degree Required skill - prior hands-on experience with configuration (setting up) of the system for one of the following: Provider contracts, Fee Schedules or benefit engine Required prior management experience