Manager Health Plan Operations Job Listing at MedStar Medical Group in Baltimore, MD (Job ID req46419)

Description

General Summary of Position
The Manager of Health Plan Operations has responsibility for providing leadership and management of the BPAAS vendor in the areas of claims, enrollment, customer service and payment integrity related services, including processing, auditing, research, and resolution, reporting and process improvement. The Manager reports directly to the Vice President of Operations and partners with other departmental managers and external vendors on all strategic and tactical matters as they relate to claims adjudication and payment, enrollment, customer service and payment integrity.

Primary Duties and Responsibilities

Minimum Qualifications
Education

• Bachelor's degree required

Experience

• 5-7 years In health plan or managed care operations required
• One year of relevant professional-level work experience may be substituted for one year of required education.

Licenses and Certifications

• CPC (Certified Professional Coder) certification preferred

Knowledge, Skills, and Abilities

• Ability to create reports in SQL and analyze large sets of complex data.
• Knowledge of all aspects of operations including claims auditing, coding, enrollment and customer service functions.
• Strong decision making ability and proficiency with Microsoft Office suite.
• Excellent verbal and written communication skills.

This position has a hiring range of $80,995 - $152,027