Medicare Advantage Manager

Position Code: 318

Department:  Account Management
Location: Little Rock, Arkansas
Immediate Supervisor:  Mike Castleberry
Status: Exempt
Posted: March 02 2017

Essential Functions of Job:

• Interview, hire, train, audit and review team members • Lead, supervise, motivate and monitor team members to ensure compliance with company policies, procedures and standards • Support and assist team members with difficult issues concerning work and offer suggestions to assist in the process of underpayment reviews and collections • Investigate various issues with Medicare Advantage and Traditional Medicare carriers and contracts; respond to questions and resolve problems • Ensure team successfully achieves quality, productivity and collection goals • Participate in workflow examination or special projects as directed by management • Build strong, lasting relationships with clients, payors and personnel • Ability to comply with internal and external audit procedures and requests • Maintain regular contact with necessary parties regarding claims status including payors, clients, managers and other personnel • Ability to read and interpret an extensive variety of documents such as contracts, claims, instructions, policies and procedures in written (in English) and diagram form. • Attend client, department and company meetings • Ability to report to the office

Qualifications:

• College degree preferred. Master’s Degree in related field considered a plus. Experience considered in lieu of degree • Effective organizational and prioritization skills • Excellent oral and written communication skills • Ability to work in a fast paced multi-tasking environment • Advanced knowledge of Microsoft Office software applications (Word, Excel, Outlook, Access) • Strong analytical, organizational, planning and problem solving skills • Knowledge of Medicare claims submittal process and procedures and medical forms a plus • Knowledge of HEDIS/ STAR elements of Medicare Advantage Operations • Good interpersonal skills to interface one on one with major auto account, union, internal support areas, or external organizations involved in servicing the account

 

The Company considers applicants without regard to race, color, national origin, sex, religion, mental or physical disability, marital status, age 40 years and over, sexual orientation or gender identity, veteran's status, or other characteristic protected by applicable law.

Applications for this vacancy will be received for 3 working days after the Posted date from Employees of HealthSCOPE Benefits with more than one year of service.

Applications for this vacancy will be received for 10 working days after the Posted date from External Applicants.