Job ID: J132213
Company: Highmark Health
Location: Pittsburgh, PA, United States
Full/Part Time: Full time
Job Type: Regular
Posted at: Sep 23, 2018
I. GENERAL OVERVIEW:
The Supervisor Performance Measurement Reporting provides day-to-day oversight and supervision of sampling, auditing, and reporting activities within Performance Measurement and Reporting (PMR) operations. The scope of responsibilities is broad based, covering claim, customer service and enrollment transactions. In addition the position is responsible for supervising all facets of the audit function, which includes, but is not limited to: promoting quality within the company; interpreting and applying quality program requirements and mandates and ensuring compliance; publishing performance results (internally and externally); and leading or supporting BlueStar system project activity. This position also ensures an effective Audit-to-Operations feedback loop and is responsible for administrative duties such as recruiting, training and developing of staff, mentoring and coaching, assessing performance and developmental needs, and contributing to the development of effective strategic and succession plans.
II. ESSENTIAL RESPONSIBILITIES:
1. Ensure an effective Audit-to-Operations feedback loop, by providing specific and detailed audit results to management, thereby facilitating action by Operation’s in addressing/resolving any control or workflow weaknesses.
2. Supervise PMR operations—oversees all activities related to day-to-day audit operations, which includes designing and maintaining statistical sampling plans, assigning and monitoring staff work, researching and interpreting audit requirements, resolving error disputes, and modifying audit methods, procedures, processes and protocols to accommodate changes in Operations and corporate technologies, etc.
3. BlueStar system projects—this is a technical component of the job that involves leading or supporting system projects and activities related to the maintenance or development of Bluestar, relative to primary areas of responsibility. This includes developing project plans, requirements and specifications, designing formats, panels and data views, researching and resolving problems, requesting program or table changes or updates and conducting user testing, etc.
4. Reporting—includes the compilation, tracking, trending, analysis and reporting of performance results.
5. Staff development—this aspect of the job requires training, coaching and mentoring staff and participating in the succession planning process, as well as performing administrative duties such as recruiting, conducting performance reviews, approving and managing time and attendance, holding staff meetings, managing system accesses, etc.
6. Other duties as assigned or requested.
Knowledge, Skills and Abilities
IV. SCOPE OF RESPONSIBILITY: (People Management Responsibility)
Does this role supervise/manage other employees? Yes
If yes, indicate the number of direct reports:
V. WORK ENVIRONMENT:
Is Travel Required? Yes
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)
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