Sr Manager TPL Programs, Coordination of Benefits

4 weeks ago

Shrewsbury, United States InsideHigherEd Full time
Overview

The Benefit Coordination and Recovery (BCR) team is seeking a Senior Manager who will oversee department operations, contract management, and revenue and recovery projects.  Under the general direction of the Deputy Director, or designee, the Senior Manager will lead the BCR teams project activities, supervising all aspects of projects from inception to implementation as relates to coordination of benefits & recovery.  The position will oversee the operations and financial performance of Coordination of Benefits (COB) Claims and Retroactive Medicare Recovery Project business units. The role will manage multiple concurrent cost saving projects, conducting research and analyses for assigned projects. The Senior Manager will utilize analytic consulting skills with a customer service focus to design and deliver quality products/services that meet or exceed client expectations.  The successful candidate will have an extensive medical claims billing and processing background as well as proven experience with leading teams in dynamic operation settings.

Responsibilities

• Lead and manage TPL programs, operations, and activities, and assist in the implementation of strategic goals and objectives.• Oversee and monitor activities of assigned unit.• Monitor operational efficiencies, and financial outcomes, metrics and benchmarks to provide continuity and ensure program operational success.• Make recommendations for priorities and program implementations.• Make recommendations for improvements to program operations.• Closely monitor the cost savings and revenue activities in the assigned unit to ensure the regular status of the cost avoidance and revenue targets and report on the potential risks for shortfalls or potential gains.• Develop and implement policy, procedure, and program tracking standards in regards to program monitoring and evaluation.• Evaluate and assist in implementing change and ongoing process improvements to increase the efficiency of operations and programs.• Work on TPL cost savings and revenue management projects.• Provide on the job training and orientation for employees.• Develop and implement procedures and guidelines to accomplish project objectives and goals.• Review and analyze data concerning assigned projects in order to determine progress and effectiveness and make recommendations for changes in procedures.• Perform related duties such as attending staff meetings, maintaining records, and preparing reports.• Interact and represent the department on a professional level with the Massachusetts Executive Office of Health and Human Services (EOHHS) and other government agencies. Respond to internal and external entities concerning assigned projects.• Work internally and externally to resolve discrepancies for projects.• Perform other duties as assigned.

Qualifications

REQUIRED EDUCATIONBachelor’s degree in Finance, Public or Health Care Administration, Business, or other related area.REQUIRED WORK EXPERIENCE7 – 9 years of experience in health and human services program management, fiscal management, finance, or public administrationProven skills in financial management or operational management.Thorough knowledge of the federal and Massachusetts state regulations associated with TPL program activities.Thorough knowledge of cost savings and revenue sources for health and human service programs.Experience with contract development and management.Working knowledge of Microsoft Office applications and database management.Strong management and leadership skills.

 

Preferred Qualifications:

  • Proven leadership skills; ability to successfully lead cross-functional teams using various virtual collaboration tools.
  • Strong oral and written communication skills
  • Proven medical claims and billing experience.
  • Expertise in Health Insurance and Coordination of Benefits for Medicaid, Medicare and Commercial Payers and ability to apply knowledge to maximize cost savings initiatives for MassHealth.
  • Demonstrated knowledge of cost saving and revenue activities related to health care benefit programs and payment methodologies, such as Medicare, federal and state regulation for Title XIX Medicaid, and commercial health insurances.
  • Demonstrated experience preparing project status and dashboard reports, cost savings and revenue tracking reports, project invoices, and other ad hoc reports
  • Adept at developing reports/dashboards, summarizing utilization and cost trends for internal and external stakeholders; and developing appropriate data visualization for reports
  • Working knowledge of claims processing systems and code sets (CPT-4, HCPCS and ICD-9 / ICD10); HIPAA transactions; EDI transactions, and XML
  • Demonstrated experience/skills with Data Warehouse concepts and Cognos
  • Highly proficient in Microsoft Office suite (Word/Excel/Access/PowerPoint).
  • Experience with Microsoft SharePoint or other project management tools
Additional Information

About Health Care Finance Solutions and Benefit Coordination and Recovery Team

  • Sr Manager TPL Programs, Coordination of Benefits

    2 weeks ago

    Shrewsbury, Massachusetts, United States University of Massachusetts Medical School Full time

    Overview: The Benefit Coordination and Recovery (BCR) team is seeking a Senior Manager who will oversee department operations, contract management, and revenue and recovery projects.  Under the general direction of the Deputy Director, or designee, the Senior Manager will lead the BCR teams project activities, supervising all aspects of projects from...

  • Sr. Program Coordinator

    3 days ago

    Shrewsbury, Massachusetts, United States University of Massachusetts Medical School Full time

    Overview: POSITION SUMMARY: Under the general supervision of the Director, the Senior Program Coordinator provides a full range of advanced level complex support services. This position provides oversight of all activities related to office administration and will lead small projects or subcomponents of larger, more complex project. This position will be...

  • Sr Research Program Manager

    2 weeks ago

    Shrewsbury, United States InsideHigherEd Full time

    OverviewGENERAL SUMMARY OF POSITION:Under the general direction of the Principal Investigator, or designee, the Senior Research Program Manager oversees the application, implementation, progress, and evaluation of complex multi-year, multi-site research projects. The Senior Research Program Manager coordinates and mobilizes staff, faculty, consultants and...

  • Sr Research Program Manager

    4 weeks ago

    Shrewsbury, Massachusetts, United States University of Massachusetts Medical School Full time

    Overview: GENERAL SUMMARY OF POSITION: Under the general direction of the Principal Investigator, or designee, the Senior Research Program Manager oversees the application, implementation, progress, and evaluation of complex multi-year, multi-site research projects. The Senior Research Program Manager coordinates and mobilizes staff, faculty, consultants...

  • Financial Analyst/Sr. Financial Analyst

    3 weeks ago

    Shrewsbury, United States University of Massachusetts Medical School Full time

    Overview: Under the general direction of the Sr. Finance Business Partner or Senior Director, Strategic Finance, or Director, Finance the Financial Analyst - FHC provides support of the daily financial activities of FHC business units. Including conducting financial analysis, budgeting, and planning to facilitate decision making by FHC Finance and BU...

  • Academic Programs and Training Manager- Remote

    1 week ago

    Shrewsbury, United States University of Massachusetts Medical School Full time

    Overview: Under the direction of the Senior Director of Operation or designee, the Academic Programs and Training Manager will be charged with managing membership services, training, educational and research projects, and events including an annual conference in support of the Academic Consortium on Criminal Justice Health (ACCJH). This a large association...

  • IT Program Manager

    5 days ago

    Shrewsbury, United States BJ's Wholesale Club Full time

    Join our team of more than 34,000 team members, supporting our members and communities in our Club Support Center, 235+ clubs and eight distribution centers. BJ's Wholesale Club offers a collaborative and inclusive environment where all team members can learn, grow and be their authentic selves. Together, we're committed to providing outstanding service and...

  • Program Operations Specialist

    4 weeks ago

    Shrewsbury, United States University of Massachusetts Full time

    Overview Under the general direction of the Department Manager or designee, the Program Operations Specialist will be responsible for providing technical support of specialized software applications utilized by clients. This position will specialize in Random Moment Time Study software and data requirements. The Program Operations Specialist will be...

  • Financial Analyst/Sr. Financial Analyst

    2 weeks ago

    Shrewsbury, United States InsideHigherEd Full time

    OverviewUnder the general direction of the Sr. Finance Business Partner or Senior Director, Strategic Finance, or Director, Finance the  Financial Analyst - FHC provides support of the daily financial activities of FHC business units. Including conducting financial analysis, budgeting, and planning to facilitate decision making by FHC Finance and BU...

  • Academic Programs and Training Manager- Remote

    1 week ago

    Shrewsbury, United States InsideHigherEd Full time

    OverviewUnder the direction of the Senior Director of Operation or designee, the Academic Programs and Training Manager will be charged with managing membership services, training, educational and research projects, and events including an annual conference in support of the Academic Consortium on Criminal Justice Health (ACCJH). This a large association of...

  • Financial Analyst/Sr. Financial Analyst

    2 weeks ago

    Shrewsbury, Massachusetts, United States University of Massachusetts Medical School Full time

    Overview: Under the general direction of the Sr. Finance Business Partner or Senior Director, Strategic Finance, or Director, Finance the  Financial Analyst - FHC provides support of the daily financial activities of FHC business units. Including conducting financial analysis, budgeting, and planning to facilitate decision making by FHC Finance and BU...

  • Academic Programs and Training Manager- Remote

    2 weeks ago

    Shrewsbury, Massachusetts, United States University of Massachusetts Medical School Full time

    Overview: Under the direction of the Senior Director of Operation or designee, the Academic Programs and Training Manager will be charged with managing membership services, training, educational and research projects, and events including an annual conference in support of the Academic Consortium on Criminal Justice Health (ACCJH). This a large association...

  • Project Management Coordinator

    3 weeks ago

    Shrewsbury, Massachusetts, United States University of Massachusetts Medical School Full time

    Overview: POSITION SUMMARY:   The Project Management Coordinator is responsible for assisting with the development and maintenance of project schedules, tracking progress, and anticipating and resolving project delays. Responsibilities: ESSENTIAL FUNCTIONS:  Coordinate the management of the project as assigned and facilitate meetings, stage work and...

  • Building Maintenance Associate

    2 weeks ago

    Shrewsbury, United States Advantage Tuck Group Full time

    Job DescriptionJob DescriptionDescription:Advantage Truck Group (ATG) has a new opportunity for a Building Maintenance Associate. ATG has competitive hourly pay rates, benefits and a supportive team environment. The Building Maintenance Associate position is a fast-paced role that relies heavily on the candidate’s ability to work independently and...

  • Program Operations Specialist

    2 weeks ago

    Shrewsbury, Massachusetts, United States University of Massachusetts Medical School Full time

    Overview: Under the general direction of the Department Manager or designee, the Program Operations Specialist will be responsible for providing technical support of specialized software applications utilized by clients.  This position will specialize in Random Moment Time Study software and data requirements.   The Program Operations Specialist will be...

  • Sr Employee Relations Consultant

    1 week ago

    Shrewsbury, United States University of Massachusetts Medical School Full time

    Overview POSITION SUMMARY: Under the direction of the Director of Employee & Labor Relations, the Senior Employee Relations Consultant provides guidance, support and expertise in employee relations matters to include discipline, coaching, performance management, HR policy interpretation. Key objectives include ensuring legal compliance and adherence to...

  • Sr Employee Relations Consultant

    4 weeks ago

    Shrewsbury, United States University of Massachusetts Medical School Full time

    Overview: POSITION SUMMARY: Under the direction of the Director of Employee & Labor Relations, the Senior Employee Relations Consultant provides guidance, support and expertise in employee relations matters to include discipline, coaching, performance management, HR policy interpretation. Key objectives include ensuring legal compliance and adherence to...

  • Assistant Residential Coordinator

    4 weeks ago

    Shrewsbury, United States MAB Community Services Full time

    Job DescriptionJob DescriptionJob Title: Assistant Residential CoordinatorDepartment: Adult Disability ServicesReports To: Residential CoordinatorFLSA Status: Non-ExemptSUMMARYUnder the general supervision of the Residential Coordinator, the Assistant Residential Coordinator provides support to participants with the goal of maximizing their capacity for...

  • Assistant Residential Coordinator

    1 month ago

    Shrewsbury, United States MAB Community Services Full time

    Job DescriptionJob DescriptionJob Title: Assistant Residential CoordinatorDepartment: Adult Disability ServicesReports To: Residential CoordinatorFLSA Status: Non-ExemptSUMMARYUnder the general supervision of the Residential Coordinator, the Assistant Residential Coordinator provides support to participants with the goal of maximizing their capacity for...

  • Assistant Residential Coordinator

    4 weeks ago

    Shrewsbury, United States MAB Community Services Full time

    Job DescriptionJob DescriptionJob Title: Assistant Residential CoordinatorDepartment: Adult Disability ServicesReports To: Residential CoordinatorFLSA Status: Non-ExemptSUMMARYUnder the general supervision of the Residential Coordinator, the Assistant Residential Coordinator provides support to participants with the goal of maximizing their capacity for...