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Manager of Payment Integrity Support Services

Cambia Health Solutions

This is a Full-time position in Seattle, WA posted November 30, 2020.

-Job Description—-Manager of Payment Integrity Support ServicesPortland, OR; Lewiston, ID; Burlington, WA; Seattle, WA; Tacoma, WA; Boise, ID; Salt Lake City, UT; Medford, OR; Salem, OR; Telecommute within WA, OR, UT, or IDLeads the Payment Integrity Support Services Team with the development and implementation of data quality and decision support systems/tools, Healthcare claims data research, Vendor Performance and Program Management and Payment Integrity market research (policy, benchmarking, vendor capabilities, etc.).

Works cross functionally to identifies and implements technologies, workflows, and sourcing partnerships to effectively meet strategic commitments.

Identifies strategies to align and effectively support operational data and metrics with changing business needs.General Functions and Outcomes* Participates in the hiring process, provides on-going coaching, employee development and writing of performance reviews.

Develops and maintains desk reference guides on work procedures.

Ensures new hires complete necessary training.

Assesses training needs and plays an active role in development of staff.* Assigns and prioritizes work, sets goals, and coordinates daily activities of the team.

Provides regular updates and communication to staff through 1:1 and team meetings.* Performs statistical analyses with existing data sets.

From results, creates visual representations and summary reports of data findings in a variety of formats.

Creates influential dashboards and presentations that use information to influence senior leadership on Payment Integrity status, trends and forecasts.* Supervises and/or leads the efforts to develop methodologies and approaches to new tasks and projects through design and development of analytical models, reports, coding material and other resource material.* Supervises the Strategies of managing our supplier relationships including but not limited to monitoring performance, process and implementation related to the suppliers* Supervises and takes responsibility for large-scale vendor relationships with direct responsibility for vendor performance and deliverables with significant impact on the company’s strategies and mission.* Supervises and Develops focus area knowledge and expertise within the vendor management space to further understand company-wide needs and deliverables from vendors and fosters an environment of continuous learning and focus with business partners.* Develops and deploys internal strategies and capabilities in support of Payment Integrity.* Identifies Payment Integrity business needs and introduces novel solutions, while operating with a high degree of independence.* Works both independently and as part of a larger team supporting various internal customer groups on identifying business challenges and evaluating solutions to achieve objectives.* Completes analysis and applies judgment to derive recommendations for complex challenges and initiatives.* Supervises and/or leads the effort toward development and execution of, data governance, database creation and maintenance, statistical analysis and data modeling.* Oversees and/or delivers the training of new staff and cross training of existing staff to ensure full coverage.

Monitors staff workloads and work quality.* Work with departments responsible for transactions systems to assure reporting data is captured and the integrity and reliability of the data is maintained.* Train and collaborate with others within the department on data analysis, use of data tools, reporting algorithms and in query and report preparation.* Maintain existing and develop new information reporting systems to support requirements of internal and external users.* Participates on cross divisional project teams to identify a problem, recommTo view the full job description

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