Provides overall operational and strategic direction for the for Information Technology (IT) solution development team and designated projects including coordinating and managing individuals in activities related to the solution development, implementation and repair of information systems. This role is within our Enterprise Population Health and will focus on payer Claims Operations data.
Major Responsibilities
Participates in solution development and system repair tasks, including identification of requirements, design specifications, developing solutions, testing, training, implementation coordination and issue management. Provides regular and comprehensive status reports to management. Leads cross-functional teams through all aspects of project planning, implementation and completion.
Manages project implementation schedules. Analyzes plan variances and takes appropriate action to ensure successful completion.
Establishes detailed work plans and estimates for all project phases. Monitors progress against baseline plans. Facilitates timely resolution of issues.
Assists with the appropriate integration of technology and ensures that initiatives are aligned to key business drivers/goals of the customer.
Creates, monitors and manages staffing levels and production expectations to meet needs.
Works with vendors to resolve all product issues, provides product development guidance and escalates major vendor service issues. Establishes service level agreements, and quickly resolves all deficiencies.
Provides status and issue updates to end user management and key stakeholders.
Promotes independent and team continued research and investigation into new technologies and solutions in order to offer solutions to requirements presented for a solution.
Performs human resources responsibilities for staff which include interviewing and selection of new employees, promotions, staff development, performance evaluations, compensation changes, resolution of employee concerns, corrective actions, terminations, and overall employee morale.
Develops and recommends operating and capital budgets and controls expenditures within approved budget objectives.
Responsible for understanding and adhering to the organization's Code of Ethical Conduct and for ensuring that personal actions, and the actions of employees supervised, comply with the policies, regulations and laws applicable to the organization's business.
Education Required
Bachelor's Degree (or equivalent knowledge) in Information Technology or related field.
Experience Required
Typically requires 5 years of experience in solution development and support. Includes 1 year of supervisory experience in a multi-discipline environment (including matrix management).
Knowledge, Skills & Abilities Required
Demonstrated knowledge of enterprise organization structures/workflow and business system architecture and technology.
Ability to interact and work through technical requirements with clients to formulate project design and implementation requirements.
Demonstrated negotiation and facilitation skills and ability to explain/communicate technical design decisions to users.
Demonstrated strong written and verbal communications skills when consulting with internal and external partners.
Demonstrated leadership abilities to include project/staff coordination, motivating staff toward common goals, and mentoring new and existing staff.
Ability to handle multiple tasks, set appropriate priorities and accomplish assignments in a thorough and timely manner.
Strong organizational and analytical skills. Ability to gather, organize and present data.
Strong problem and issue resolution skills.
Ability to handle multiple tasks, set appropriate priorities and accomplish assignments in a thorough and timely manner.
Additional Skills Required
Strong understanding of Claims Operations business workflows.
Ability to work with various business units and external users such as payers to understand their requirements. Then develop technical solutions that meet the requirements.
Demonstrated ability to support Claims Operations eligibility data flows. This includes ability to ingest payer specific data (flat files, EDI 834, etc.), apply business rules and ingest into downstream systems such as Epic Tapestry.
Demonstrated ability to support Claims Operations workflows such as 278 encounter submissions.
Demonstrated ability to support a home-grown provider network database application. Abilities include supporting the back-end data interfaces as well as managing the development of the front-end application.
Ability to develop and support reports used by Claims Operations. This should include an understanding of the business workflows/requirements and developing report solutions to meet those needs.
#Remote
Seniority level
Not Applicable
Employment type
Full-time
Job function
Information Technology
Industries
Hospitals and Health Care
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