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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.
As
a 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.
At UCLA Health, you can help heal humankind, one patient at a time by improving health, alleviating suffering and delivering acts of kindness. As you do, you’ll achieve great things in your life and your career. We’re a world-class health organization with four hospitals consistently recognized among the nation’s very best as well as an internationally-renowned medical school, primary and specialty care clinics and much more. Within our dynamic, innovative and growing organization, you’ll find exceptional opportunities to make the most of your abilities in a supportive, empowering and inclusive environment. If you embrace our values of Integrity, Compassion, Respect, Teamwork, Excellence and Discovery we invite you to see all you can accomplish at UCLA Health.