Healthcare Operations Manager

1 week ago


Monsey, New York, United States Health First Full time
Job Responsibilities

The Healthcare Operations Manager will oversee the setup of code sets, define pre-authorization guidelines, and collect and analyze data to assess operational obstacles to claims configuration design optimization. You will perform root-cause analysis on claims configuration issues, document results, and present business impact analysis for proposed changes.

This role requires strong analytical and communication skills, with the ability to work effectively with various departments and stakeholders. Proficiency in medical terminology, medical coding, and provider contract concepts is essential. Experience with analysis tools such as SQL, SAS, Alteryx, AWS, Python, and/or Tableau is highly preferred. A bachelor's degree in a related field is required.


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