Reimbursement Operations Manager

McKesson   •  

Scottsdale, AZ

Industry: Healthcare

  •  

5 - 7 years

Posted 29 days ago

This job is no longer available.

Position Description

Contact center management for a variety of product support programs that manage client reimbursement needs. This position is responsible for the overall management of program operations including, but not limited to, staffing, profitability, standard operating procedures, process design, process implementation and process improvements. This position will monitor client Service Level Agreements (SLA) to ensure compliance and make staffing and process changes and improvements if SLA is not being met. This position will provide supervisory guidance to direct reports and monitor performance based on job descriptions and expectations of the subordinate positions. This position will also act as a liaison between Client Services, Information Systems, Business Analysts, Quality Assurance and Training to achieve synergy of processes, training, efficiency and ultimately, customer satisfaction.

Key Responsibilities:

  • Manage Customer Service Supervisors, performance to be measured against job descriptions and Roles and Responsibilities. Apply development program for all direct reports.
  • Ensure SLA's are met, maintained and improved if possible.
  • Maintain and monitor program profitability
  • Works closely with Supervisors to assure that McKesson is in compliance with all government regulatory anti-fraud and abuse statutes.
  • Develop standardized policies and procedures.
  • Effectively act as Liaison between all internal and external customers to provide excellence in Customer Service
  • Effectively handle multiple priorities within a changing environment

Minimum Requirements

5+ years customer service experience including 2+ years managerial experience, depending on area of assignment may be required to have relevant healthcare/insurance experience

Critical Skills

  • Experience in the healthcare industry including, but not limited to, Medicare and/or Medicaid program administration, insurance verification and/or claim adjudication, physician's office or outpatient billing, pharmacy and/or pharmaceutical manufacturers.
  • Experience in managing larger healthcare programs with 50-100 agents.
  • Understanding of Alternate Funding and Patient Assistant Programs.
  • Experience with Public (Medicare/Medicaid) and/or Commercial insurance.
  • Experience in program implementation, maintenance and restructure.
  • Ability to analyze reimbursement specific data and prepare written reports for upper management and client communications.
  • Experience meeting or exceeding multiple SLAs for the program.
  • Experience in budget, staffing and profitability models.

Additional knowledge and skills

  • Ability to apply Contact Center and Customer Service best practices, preferred
  • Understanding of ICD-10, ICD-9, CPT, and HCPCS, desired

Education

4-year degree in business or related field or equivalent experience