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Program Manager Benefit Interpretation
3 months ago
Why Choose Jefferson Health Plans?
We are an award-winning, not-for-profit health maintenance organization. We are committed to creating a community where everyone belongs, acknowledges, and celebrates diversity and has opportunities to grow to their fullest potential.
We offer Medicaid, Medicare, and Children’s Health Insurance Program (CHIP) plans that include special benefits to improve the health and wellness of our members. We’re also committed to boosting the health of our community through outreach, education, and events. Founded over 35 years ago, Jefferson Health Plans continually develops new ways to encourage better health outcomes and has received national recognition for our innovations in managed care.
While this job currently provides a flexible remote option, due to in-office meetings, training as required, or other business needs, our employees are to be residents of PA or the nearby states of DE or NJ.
Perks of JHP and why you will love it here:
Competitive Compensation Packages including 401(k) Savings Plan with Company Match and Profit Sharing Flextime and Work-at-Home Options Benefits & Wellness Program including generous Time Off Impact on the communities we service We are seeking a talented and enthusiastic Program Manager, Benefit Interpretation to join our team
Working under minimal supervision responsible for direction, coordination, development, evaluation and compliance of member benefits for all Jefferson Health Plans lines of business. Uses in depth knowledge of medical coding, reimbursement, clinical operations, and standard benefits for public programs to ensure accurate and efficient implementation of benefit plans.
As the Program Manager, Benefit Interpretation your daily duties may include:
Qualifications
Bachelor’s Degree required and 5 years’ experience in insurance industry in areas of Benefits Administration, Health Care Management or related field. RN and/or certified coder preferred.Skills, We Value:
Must have demonstrated experience working with benefit design, preferred Medicare and Medicaid Ability to mine data and content, develop presentation and communicate concepts Experience with process improvement concepts and applications Excellent communication skills, including the ability to interface with all levels of management Detailed oriented with significant knowledge of heath care and public policy Demonstrated ability to lead and effectively work with multidisciplinary teams Strong problem solving skills PC Skills ( Word, excel, power point)-
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