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Senior Manager, Benefits Configuration Implementation Services (BCIS)

at HMSA

Posted: 10/2/2019
Job Reference #: 5000527558106
Keywords:

Job Description

Employment Type

Full-time

Exempt or Non-Exempt

Exempt

Job Summary

The Senior Manager provides leadership, management, and direction for the BCIS Agile Teams and their related functions having as their purpose the administration and implementation of policies, programs, benefits, contracts and payment methodologies, all of which support timely and accurate claims processing. They provide subject matter expertise for designated activities of their teams including QNXT architecture and configuration, testing and solution deployment.

 

A person in this position is expected to be thoroughly familiar with claims processing goals and objectives, medical and payment policy objectives and benefit provisions. The Senior Manager displays technical competence in order to oversee and provide leadership as required for the development of QNXT (or alternative system) solutions, architecture standards and policies as well as the unit and systems testing of configuration solutions. They are knowledgeable and proficient in directing and overseeing a Systems Development Lifecycle for both Agile and Waterfall methodologies. In addition, they help facilitate and ensure the needs and requirements of all key stakeholders are prioritized appropriately and are satisfactorily met through the coordination and exchange of information on initiatives, expectations, issues and problem situations.

 

The Senior Manager is well versed in a variety of processes and concepts as it relates to the subject areas noted above. They engage and facilitate discussion and debate to drive decisions in these areas and represent the department on key decision-making committees and cross departmental initiatives as well.

Minimum Qualifications

  • Bachelor's degree (B.A.) and 6 years of related work experience, including 1 year in healthcare operations; or equivalent combination of education and experience.
  • 2 years of related technical experience in testing and application development and/or business experience in healthcare plan operations.
  • 3 years of previous management/supervisory experience
  • Strong written and verbal communication skills
  • Strong planning, organization, and time management skills
  • Intermediate working knowledge of Microsoft Office applications. Including but not limited to Word, Excel, and Outlook.

Duties and Responsibilities

1. Direct and manage unit and team to ensure metrics and goals are achieved, compliance with Federal, SSAE18 and others is adhered to, the desired level of Measure Touchpoint Measure (MTM) points are met and customer SLAs are consistently achieved:
  •  Understand and provide leadership concerning Agile/Scrum practices
  • Develop and implement suitable test strategies, methodologies, processes and standards, employing industry best practice.
  • Procure and maintain necessary configuration and testing tools within an agreed budget.
  • Establish, implement and maintain Quality Assurance (QA) and audit procedures to ensure accurate and timely deliverables.
  • Develop standard operating procedures and guidelines, establish and maintain key management reports, and ensure team/unit service level agreements/metrics are met.
  • Review and assess at a frequency agreed upon with the department head, the effectiveness of standards and procedures re: configuration, QA, testing and deployment. Develop an action plan and manage the implementation of necessary changes to ensure continuous improvements are made.
2. Interacts routinely with a variety of customers and stakeholders from Execs, Department Heads and Management through analysts to lead, manage and/or collaborate in the following activities:
  • The development of both unit and department plans that ensures alignment with both Internal Operations' and HMSA's goals and objectives
  •  Provide vendor management support via collaborating and planning with QBOT and others for QNXT platform upgrades and testing as well as the testing and deployment of QNXT enhancements
  • Effectively collaborate with Information Systems and vendor management to ensure that the vendor is meeting their performance guidelines and service commitments.
  • Develop collaborative and complementary working relationships with internal departments such as Claims Operations, AMS, MPS, Provider Services, etc.
  • Lead or actively engage in the discussion and resolution of complex business problems and the development of application/testing solutions.
  • Lead or actively engage in various meeting forums that discuss and direct strategies re: QNXT Platform architecture and/or product direction, application life cycle development and governance and various types of testing from unit through user acceptance
 
3. Manage and direct the overall administration of the BCIS teams and related areas.
 
  •  Attract: Attract high quality high performing individuals to become a part of the BCIS teams. Carefully interviewing and selecting potential candidates to ensure a proper fit for the department and organization. This may include thinking outside of the box in light of the ever changing and challenging hiring climate. Thus driving department goals and initiatives towards optimal levels.
  •  Manage: Responsible for the management of all employees in assigned area. This includes staffing, benefits, compensation, scheduling, performance management, employee relations issues, training, and development. The goal is to successfully achieve corporate and departmental goals and objectives.
  • Develop: Create and nurture a favorable employee relations environment. Will motivate and coach BCIS team members to constantly improve themselves and their work quality. Through the consistent reviews and PMP processes to ensure that performance issues are identified and improvement plans are discussed. Giving all staff members the opportunity to become the best that they can be. Ultimately driving the development and career pathways for subordinate
4. Other duties/functions
  • Performs all other miscellaneous responsibilities and duties as assigned or directed