Description
Take
on a significant role within a world-class health organization. Elevate the
operational effectiveness of a complex health system. Take your professional
expertise to the next level. You can do all this and more at UCLA Health.
Asa key member of our Medicare Advantage
Operations team, you will develop detailed requirements specifications to meet
our business needs. This will involve working directly with and serving as a
liaison between business units, external trading partners, IT, and support
teams. You will:
Ensure functional and non-functional requirements are understood and implemented
Perform testing, design, and delivery requirements
Identify, analyze, quantify, and mitigate business risks
Deliver and update training documentation
Generate ad hoc reports to support the operations team
Salary Range: $76,200 - $158,800/annually
Qualifications
We're
seeking a self-motivated, adaptable, customer-focused, results-driven
individual with:
Required Bachelor's degree in business, information systems, healthcare, or a related field
Five or more years of experience managing enrollment, claims, or encounters in a Medicare or managed care environment required
Five or more years of experience with CMS processes required
Computer proficiency with Microsoft Office, SQL, and data visualization tools
Knowledge of encounter regulatory reporting and compliance requirements
Experience managing vendors to contractual requirements
Ability to research and resolve encounter issues
Understanding of the healthcare model, capitation, and other managed care IPA and provider reimbursement methodologies
Knowledge of physician/facility billing practices, CPT coding initiatives, ICD-10 coding standards, and revenue and HCPCS coding
Strong leadership, interpersonal, analytical, problem-solving, and prioritizing skills
Excellent oral and written communication skills
Ability to develop, implement, and evaluate methods and systems to improve efficiency
Ability to work well independently as well as part of a team
UCLA Health is a world-renowned health system with
four award-winning hospitals and more than 260 community clinics throughout Southern
California. We are also home to the David Geffen School of Medicine, a highly
respected leader in the development of breakthrough medical research and
outstanding clinical professionals. If
you're looking to experience greater challenge and fulfillment in your career, you
can at UCLA Health.
UCLA Health welcomes all individuals, without regard to race, sex, sexual orientation, gender identity, religion, national origin or disabilities, and we proudly look to each person's unique achievements and experiences to further set us apart.