Healthcare Claims Senior Manager

Healthcare Claims Sr Manager

Drive better health outcomes for our clients as a Healthcare Claims Sr Manager at GDIT. Here, your work will impact many as you deliver healthcare expertise and services where they are needed most. Own this opportunity to advance not just, patient outcomes, but also your personal career growth.

At GDIT, people are our differentiator. As a Healthcare Claims Sr Manager, you will help ensure today is safe and tomorrow is smarter. Our work depends on Healthcare Claims Sr Manager joining our team to manage staff and key deliverables to meet service agreements and consistently deliver high quality and timely service.

HOW A SENIOR MANAGER HEALTHCARE CLAIMS WILL MAKE AN IMPACT

• You will act as a thought partner to the leadership team to provide support and counsel for operations management, communications, initiatives and projects.
• You should be a self-starter with outstanding organization and communication skills, fast paced environment.
• Understand strategic financials regarding areas of oversight.
• Proven ability to build strong partnerships with colleagues, desire to be flexible and think proactively, strategically, and analytically about diverse business solutions and leading professional working groups.
• Ability to make critical decisions with limited guidance while ensuring visibility into those decisions.
• A demonstrated understanding of Medicaid support operations and an appreciation for how to prioritize among demands and balance the levers that make a complex business run smoothly and productively.
• Manages Provider Enrollment operations for NCMMIS program, including optimizing resources to facilitate SLA deliverables and maximize efficient operations.
• Manages change management efforts and reporting to optimize SLAs and ensure optimization of resources.
• Serve as lead cross departmental deliverables for operations, including internal and external audits, business continuity, and other program operations deliverables.
• Serve as a resource for operational managers and assist with training and mentoring operational managers regarding key operational processes.
• Lead cross departmental operational efforts for internal and external quality assessments, audits and surveys.
• Lead cross departmental communication initiatives to both internal and external stakeholders, including community engagement efforts and efforts to facilitate employee engagement.
• Manage and oversee key departments, including training and operational data efforts to optimize efficiencies and ensure effective operations.
• Oversee and coordinate NCQA CVO efforts and all supporting efforts.
• Manages and optimizes customer and key stakeholder relationships, including escalations and developing processes to facilitate timely management of provider enrollment related escalations.

WHAT YOU’LL NEED TO SUCCEED:

• Education: Bachelor's Degree in related technical, scientific, business, health or a related discipline
• Required Experience: 5+ years of related experience
• Required Skills and Abilities: Medicaid Operations Leadership Support , Project Management Skills, Provider Enrollment Management Skills and Experience, NCQA CVO knowledge and experience.
• Demonstrated ability to communicate issues, impacts, and corrective actions
• Demonstrated ability to easily and effectively communicate project topics to a diverse audience
• Demonstrated ability to clearly report relevant information
• Preferred Skills: SharePoint, Excel, PMO, PowerPoint
• Location: Hybrid
• US Citizenship Required

GDIT IS YOUR PLACE:

• 401K with company match
• Comprehensive health and wellness packages
• Internal mobility team dedicated to helping you own your career
• Professional growth opportunities including paid education and certifications
• Cutting-edge technology you can learn from
• Rest and recharge with paid vacation and holidays