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Mgr, Claims

Company: CareSource
Location: Dayton
Posted on: January 13, 2019

Job Description:

Role and Responsibility:* Provide leadership and direction to team to ensure the goals and standards of the department and CareSource are being met* Guide team leads and analysts relative to daily operational functions* Ensure quantitative and qualitative measures are used to meet performance objectives* Manage staffing and scheduling functions* Engage direct reports through consistent performance feedback and development opportunities* Compile reports and departmental communications* Participate in strategic planning and implement action plans* Interface with team leads on effective people management strategies such as staffing, coaching and mentoring* Lead/participate in strategic department/company projects* Identify and facilitate process improvements to improve productivity, accuracy, and data usability* Maintain positive relationship with internal and external customers* Perform any other job related instructions, as requested Requirements Education / Experience:* Bachelor's degree in business administration, healthcare or related field or equivalent years of relevant work experience is required* Minimum of three (3) years of healthcare experience, to include one (1) year of claims or operations experience is required* Minimum of two (2) years of previous leadership experience is required* Managed care experience preferred Required Competencies / Knowledge / Skills:* Proficiency in Microsoft Excel and Word* Working knowledge of medical claims workflow and processing applications* Knowledge of regulatory reporting and compliance requirements for Medicaid and Medicare* Knowledge of managed care industry, claims trends and best practices* Familiar with Agile methodology and application* Advanced working knowledge of managed care concepts and HMO claims required* Experience with managing inventory and workload aging* Ability to track/trend provider claim issues and develop solutions* Excellent communication skills; both written and verbal* Strong leadership experience and skills* Experience in engaging front line associates and building teams* Knowledge of medical coding (CPT / ICD-9) desired* Ability to work independently and within a team environment* Attention to detail* Knowledge of Medicaid / Medicare* Proper grammar usage* Time management skills* Customer service orientation* Effective decision making/problem solving skills* Capable of multitasking and prioritizing work* Ability to effectively interact with all levels of the organization Licensure / Certification:* None Working Conditions:* General office environment; may be required to sit/stand for long periods of time Apply On-lineSend This Job to a Friend Copyright ? Ultimate Software

Keywords: CareSource, Dayton , Mgr, Claims, Other , Dayton, Ohio

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