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The Medicare Administration department is responsible for Medicare product performance by setting strategic goals and initiatives to meet product goals. The department works primarily in a matrix business model partnering with other Banner Insurance Division departments and Banner Health Systemwide departments to achieve the product goals.
The Senior Manager Medicare Administration will be responsible for managing the strategies for the DSNP and MAPD STARS, Model of Care and strategies for both product lines tied to product performance. A strong candidate will have experience with project management with a strong analytical mindset. Organization and the ability to absorb and track a lot of activity will be key. Collaboration with external and internal customers in a highly matrixed organization with excellent communication and partnership. Strong ability to create and present dashboards and reports. Excellent presentation skills in power point, Visio, and Excel. This is a remote working opportunity from Phoenix or Tucson, Arizona or Northern Colorado to support the Insurance Division.
Banner University Health Plans (BUHP) manage a variety of health plans. Our mission is to advance health and wellness through education, research and patient care. About Banner Health Banner Health is one of the largest, nonprofit health care systems in the country and the leading nonprofit provider of hospital services in all the communities we serve. Throughout our network of hospitals, primary care health centers, research centers, labs, physician practices and more, our skilled and compassionate professionals use the latest technology to make health care easier, so life can be better. The many locations, career opportunities, and benefits offered at Banner Health help to make the Banner Journey unique and fulfilling for every employee.
POSITION SUMMARY This position is responsible for assisting with ensuring operational support for all programmatic functions within the Medicare division that will drive superior product performance. The position will provide ongoing compliance and operational performance of new and existing Medicare programs and projects. This individual will work with and lead and develop a team of people who will support the sales and enrollment functions from a work flow, policies, procedures, regulatory and compliance perspective. Works both independently and collaboratively with all health plan functional areas with the purpose to support the development, implementation, maintenance, monitoring, and continuous improvement of Medicare Sales, Enrollment and Operations. The Medicare Sales Senior Manager will work closely with the Medicare Administrator to create a metric driven and results reporting environment to manage the strategic and tactical side of the business. ABC submission, annual readiness review, policy and procedure documentation and implementation. This position will have responsibility for supervising a support staff and directing the Medicare Sales operations implementation and the on-going operations of these individuals who provide the clerical and technical support for the Sales Department. This person will be involved in cross-functional projects to support larger Medicare initiatives.
CORE FUNCTIONS 1. Ensures all Medicare regulatory and policy guidance are disseminated and trained in a timely manner with the business partners to insure that such guidance is strictly adhered to, implemented and monitored and that evidence of implementation is verified and documented pertaining to the Model of Care and 5 Star Measures.
2. Manages and oversees the product strategic plan which includes developing the initiatives with each matrix area and setting up follow up meeting and tracking documents to insure we are achieving towards the agreed upon goals.
3. Assists all functional areas with ensuring they are aware of the most current deliverables are on track and assist the functional areas with any challenges or items at risk by raising those concerns to the Medicare Administrator directly through updates or a dashboard reporting meeting for use.
4. Attends all relevant CMS and AZDOI user group calls and meetings and disseminates and trains on appropriate material from the calls/meetings.
5. Assists with researching and tracking the Medicare regulatory environment and initiatives in collaboration with Government Programs and Compliance Departments. Ensures the regulatory reporting requirements, training and oversight for the Medicare LOB are timely, accurate and compliant.
6. Collaborates with other Health Plan Departments to ensure effective partnerships are developed and maintained. Maintains knowledge of to communicate trends within our markets and the industry overall.
7. Reports to the Medicare Administrator and will have responsibilities to ensure the overall program aspects of the Medicare products area and other duties as assigned
Must possess knowledge as normally obtained through the completion of a bachelor's degree in health care administration, finance administration or organizational/project management.
Three or more years of Medicare Advantage equivalent combination of operational work experience. The work requires a high degree of organization, the ability to manage time and resources effectively, and the self-starter ability to work independently to achieve goals. Effective customer service and interpersonal relations skills are necessary. The ability to communicate effectively verbally, in writing and through common computer software is required.
Excellent Microsoft Office Suite Skills including Visio with a focus on developing dashboards and presentations. Excellent Power Point and Excel skills needed and MicroSoft Project.
Additional related education and/or experience preferred.
DATE APPROVED 11/29/2020
Internal Number: R17399
About Banner Health
You want to change the health care industry – one life at a time. You belong here. You’re excited to be part of the dramatic changes happening in the health care field. In fact, you thrive on change. But you also understand that excellent, compassionate patient care is the true measure of the success of these changes. You belong at Banner Health. Our award-winning, comprehensive health system includes 23 hospitals in seven western states, primary care health centers, research centers, labs, a network of physician practices and much more. Throughout our system, skilled, compassionate professionals use the latest technology to change the way care is provided. If you’re looking to be a key contributor to a forward-looking organization, you’ll experience a wide variety of professional advantages: •Our vision for changing the future of health care gives you the opportunity to leverage your abilities to achieve something historic. •Our expansive system offers you an unmatched variety of clinical settings – from large urban trauma center to small rural hospital, ambulatory to home health. Our system also includes hospitals specializing in cancer, heart health and pediatrics. •Our many loc...ations also translate into a broad selection of exciting and rewarding lifestyle options – from the big city to the wide-open spaces. •Our commitment to healthcare innovation means you always have the latest technologies at your fingertips to help you provide the finest care possible. •The size, success and growth of our system provide you with the stability and options to pursue your desired career path. •Our competitive compensation and comprehensive benefits offer you options to complement your unique needs.