Manager, Network Operations Improvement – Policy
Capital Blue Cross
full-time
Posted on:
Location Type: Hybrid
Location: Harrisburg • Pennsylvania • United States
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Salary
💰 $83,800 - $157,890 per year
About the role
- Responsible for leading analyzation, evaluation, development and implementation of new and existing reimbursement policies
- Responsible for the development, implementation and ongoing oversight of a Reimbursement Policy Committee
- Responsible with resolving reimbursement policy issues that arise either during contract settlements
- Oversight of all Network-related projects to maintain focus on timely, on-budget deliveries
- Responsible with oversight of the identification and continuous improvement of network policies and procedures
Requirements
- 5 years proven experience in market access or (provider network), reimbursement, or a related field within the healthcare industry
- Minimum 1 year staff, team lead or project lead experience
- Experience working on cross-functional teams required
- Proven leadership skills related to coaching, leading, motivating and innovating for process improvements
- Experience working with various informational or data structures include but not limited to CMS RVU files, Carrier Specific Public Use Files, Medicare Intermediaries, MediSpan, RedBook, etc.
- Strong interpersonal and communication skills
- Ability to lead discussions with vague details or little direction
- Self-motivated, quick and assertive
- Strong written and verbal communication skills
Benefits
- Competitive salary
- Flexible work environment
- Professional development opportunities
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
reimbursement policiesmarket accessprovider networkdata structuresCMS RVU filesCarrier Specific Public Use FilesMedicare IntermediariesMediSpanRedBook
Soft Skills
leadershipcoachingmotivatingprocess improvementsinterpersonal skillscommunication skillsself-motivatedassertiveteam leadership