Supervisor, Customer Implementation

Job ID: J120414
Company: Highmark Inc
Location: Camp Hill, PA, United States
Full/Part Time: Full time
Job Type: Regular
Posted at:

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Description

JOB SUMMARY

This job monitors day- to- day activities and drives project implementation within a specific health plan team. Supervises the team's work to design, develop, and implement product, client, and group demographic, benefit, and rate coding information for a particular health plan. Works with the team to review and analyze initial entry data, processes, and finalize standard and customized data, resolve client specific customer requests and write clean-up reports. Translates heath plan product information into system configuration. Ensures high-quality, accurate, efficient, customer outcomes. May conduct quality peer reviews to ensure accuracy of system configuration as compared to initial inputs. May also assist with benefit projects, root cause analysis, issue resolution and strategic initiatives. Accountable for identification, documentation, and escalation of risks, defects and issues throughout the work item lifecycle. Assists in the resolution of risks, defects and issues. May provide support for corporate projects, strategic initiatives, benefit enhancements, and application of medical policy.  For smaller projects or initiatives may be accountable for project schedule and resource allocation up to and including matrix staff. May have accountability to provide project status back to the appropriate Management group or customer, release co-coordinator and/or various project management office (PMO) groups.

ESSENTIAL RESPONSIBILITIES

  • Supervise and report on root cause analysis and coding implementation to include: Claims testing, Data clean-up, Business procedures implementation (suspense correction), Business/Technical sign-off on change results (CRs) and projects
  • Identify opportunities for and supervise implementation of operational strategic initiatives that impact and improve operational capabilities related to benefit application, product development and client administration.
  • Coach, manage, and develop the team by establishing clear goals, expectations, and strategies for performance. Implement culture of accountability, transparency, knowledge-sharing and high-quality outcomes. Promote diversity and inclusion.
  • Supervise peer reviews to ensure that all information (demographics, benefits, and rates) is accurate and complete so that downstream systems properly issue ID cards, booklets, and contracts, accurately code benefits in claims systems, and issue accurate and timely bills. Review quality results and identify improvement opportunities.
  • Supervise and report on root cause analysis and coding implementation to include:
  • Claims testing, Data clean-up, Business procedures implementation (suspense correction), Business/Technical sign-off on change results (CRs) and projects
  • Serve as point of escalation for systems-related issues to technical and lead staff, helps to identify and communicate technical specifications and solutions for system updates, data changes and data builds. Provide timely follow-up and communication on expedited and urgent issues.
  • Work with the team to analyze and communicate benefit design options to sales, operations and other areas for new clients, benefit changes requests or product interactions. 
  • Other duties as assigned or requested

QUALIFICATIONS

Minimum

  • Bachelor's Degree in Business Substitutions: 6 years of professional-level experience or equivalent combination of post-secondary education and professional-level experience in health care operations, technology delivery, or healthcare analysis/consulting (preferably with Benefits Solutions systems) accepted in lieu of degree
  • 1 - 3 years of Supervisory experience
  • 1 - 3 years of Process Improvement experience
  • 1 - 3 years of experience in Managing Technology
  • 1 - 3 years of experience working with operational computer systems

Preferred

  • 3 - 5 years of Supervisory experience
  • 3 - 5 years of Process Improvement experience
  • 3 - 5 years of experience Managing Technology
  • 3 - 5 years of experience working with operational computer systems

SKILLS

  • Experience in health administration and benefit interpretation
  • Experience in technology applications
  • Excellent ability to identify data configuration issues and resolve them
  • Ability to present information and communicate to a large audience
  • Ability to manage teams of more than 10 employees
  • Strong oral and written communication skills
  • Ability to maintain confidential and sensitive information
  • Excellent team building and conflict resolution skills

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
EEO is The Law
Equal Opportunity Employer Minorities/Women/ProtectedVeterans/Disabled/Sexual Orientation/Gender Identity (http://www1.eeoc.gov/employers/upload/eeoc_self_print_poster.pdf)
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.
For accommodation requests, please call HR Services at 844-242-HR4U or visit HR Services Online at HRServices@highmarkhealth.org

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