Configuration Manager - Health Care

Company: P3 Health Partners
Location: Henderson
Posted on: January 22, 2023

Job Description:

P3 Health Partners is committed to ensuring the health and safety of our team members, patients and communities we serve. As a part of this commitment, all candidates must receive their COVID-19 vaccine prior to joining the team. If you have any questions about our interview and hiring procedures, please contact . People. Passion. Purpose.At P3 Health Partners, our promise is to guide our communities to better health, unburden clinicians, align incentives and engage patients.We are a physician-led organization relentless in our mission to overcome all obstacles by positively disrupting the business of health care, transforming it from sickness care into wellness guidance.We are looking for a Health Care System Configuration Manager. If you are passionate about your work; eager to have fun; and motivated to be part of a fast-growing organization in Las Vegas, Nevada, then you should consider joining our team.Configuration ManagerThe main functions of this position are leading, coaching, and guiding analysts that configure, support, and maintain the core administrative system that processes medical claims and authorizations including but not limited to: EDI transactions, provider and member data, encounters, CMS/health plan, internal reporting, benefits, and data entry. This role will be responsible for continuing to enhance the vision, value proposition, services for the configuration function and develop and align the staff in place to deliver against these services.Education:High school diploma or GED required + 6 years relevant work experienceBachelor's degree preferredKnowledge, Skills and Abilities:Required Skills:Must have a strong understanding of any local, state, and federal rules regarding the adjudication of medical benefitsStrong knowledge of CPT, HCPCS, ICD-10, DRG and APC coding and CMS Guidelines.Strong organizational and time management skills with the ability to prioritize individual workloads.Proficient in MS Office with strong computer skills (e.g. multiple systems experiences, keyboarding skills, Microsoft word, Power Point)5+ years of health care system and configuration knowledgeKnowledge of CMS reporting: ODAG and Part C5+ years encounter submission experience3 to 5 years management experience.Extensive experience in plan building, provider data maintenance and reimbursement methodologies including fee schedules, contract management and workflow processes.HMO Claims, managed care and Medicare advantage experience required.Preferred Qualifications:Experience analyzing and identifying trendsAbility to interpret electronic data interchangeAbility to drive performance managementEssential Functions:Coordinate and supervise daily/weekly/monthly activities of a team members including setting priorities for the team to ensure task completion and performance goals are metRespond configuration escalationsProvide coaching, feedback, and annual performance reviews as well as formal corrective actionManage inventory and performance to business metricsWrite and Submit P&P update requestsProvide expertise or general system configuration support to team in reviewing, researching, investigating, system configurationSupport team employee engagementCommunicate and collaborate with internal and external business partnersDocument and communicate status of system configuration to stakeholders as neededAchieve applicable performance metrics (productivity, quality, TAT, utilization)Advanced problem solving, critical thinking, and process analysis skills to lead teams responsible for client configurationUnderstanding of the healthcare industry, including competitors, the regulatory environment, and industry trendsAbility to provide strategic leadership and demonstrate the ability to develop future-state scenarios, create a vision for the future, defines factors needed to achieve success, and key actions required.Demonstrated leadership skills having lead configuration activity or function, knowledgeable about configuration best practices, methodologies, and toolsOther tasks assigned by managerEqual Opportunity Employer/Protected Veterans/Individuals with DisabilitiesThe contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)

Keywords: P3 Health Partners, Henderson , Configuration Manager - Health Care, Executive , Henderson, Nevada