Supervisor - Provider Operations Support - Health Alliance Plan - Flint
GENERAL SUMMARY:
To provide leadership, guidance, and supervision to the staff of the assigned Provider Operations Support Team. To organize, coordinate, and ensure that Team, Division, and Corporate standards are adhered to. Support and administer corporate policies, procedures, and philosophies to promote quality and consistency, and control of expense objectives.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
- Provide overall direction and immediate supervision to the assigned staff of the Provider Operations Support Team through delegation of work assignments, projects, and tasks required to satisfy divisional and corporate goals, objectives, and strategies.
- Provide courteous, professional, consistent, and timely feedback to assigned Team members and Leadership in accordance with supervisory guidelines, with respect to direct reports. Ensure Team member performance by initiating appropriate coaching, mentoring, recommending staff training, and implementing corrective action within area of responsibility. Promotes an atmosphere that encourages and fosters superior teamwork and strong work ethics. Supports Provider Operations leadership and performs management duties when necessary.
- Establish and monitor activities, which will facilitate productivity, efficiency and customer service during the completion of system related projects. Ensure that the team establishes and maintains contact with all assigned customers regarding workload and priorities.
- Oversee and participate in business user acceptance testing within Provider Operations. Create, approve and execute test conditions that meet the requirements for the system testing initiatives. Analyze and review online, hard copy and automated files to determine accuracy and completeness to ensure end results are consistent and have conformed to required HAP and regulatory standards.
- Design, document and update complex business models related to the Provider Operations Division activities. Monitor processes quarterly to ensure the financial and procedural content is accurate and up to date. Participate in development of departmental policies and procedures related to activities of Provider Operations. Analyze operating procedures, recommend forward thinking solutions, generate ideas for continuous improvement and implement approved changes. Responsible for the accuracy and clarity of all documents. Ability to be thorough and complete when working, processing, or providing information and documenting. Ability to track details and create accurate documentation even under pressure.
- Conduct routine quality audits to measure and report claim processing, payment, and financial accuracy for Provider Operations Support Team. Ensure that audits are completed timely and outcomes are reported to direct leadership. Identify and report all developmental opportunities to Claims direct leadership for coaching and potential training on a monthly basis.
- Set a positive example for the team by modeling all core company values, policies and guidelines. Design, develop and conduct various training classes for both specialized and general topics pertaining to the claims cycle, including but not limited to claim processes, system navigation, and quality control efforts.
- Perform other related duties as assigned.
- Bachelor's Degree in Computer Science, Business Administration or related field preferred.
- Related and relevant experience, progress towards a degree, or a demonstrated ability to perform the duties of the position may be considered in lieu of academic requirements.
- Five (5) years process design and implementation experience within a claim processing environment.
- Five (5) years business writing experience.
- Three (3) years of health care related business experience preferred
- One (1) year experience in a leadership role preferred
Overview
HAP is a Michigan-based, nonprofit health plan that provides health coverage to individuals, companies and organizations. A subsidiary of Henry Ford Health System, we partner with doctors, employers and community groups to enhance the overall health and well-being of the lives we touch. With more than 1,100 dedicated and passionate employees, our goal is to make health care easy for our members.
Henry Ford Health System, one of the largest and most comprehensive integrated U.S. health care systems, is a national leader in clinical care, research and education. The system includes the 1,200-member Henry Ford Medical Group, five hospitals, Health Alliance Plan (a health insurance and wellness company), Henry Ford Physician Network, a 150-site ambulatory network and many other health-related entities throughout southeast Michigan, providing a full continuum of care. In 2015, Henry Ford provided $299 million in uncompensated care. The health system also is a major economic driver in Michigan and employs more than 24,600 employees. Henry Ford is a 2011 Malcolm Baldrige National Quality Award recipient. The health system is led by President and CEO Wright Lassiter III. To learn more, visit henryford.com
Benefits
Whether it's offering a new medical option, helping you make healthier lifestyle choices or
making the employee enrollment selection experience easier, it's all about choice. Â Henry
Ford Health System has a new approach for its employee benefits program - My Choice
Rewards. Â My Choice Rewards is a program as diverse as the people it serves. Â There are
dozens of options for all of our employees including compensation, benefits, work/life balance
and learning - options that enhance your career and add value to your personal life. Â As an
employee you are provided access to Retirement Programs, an Employee Assistance Program
(Henry Ford Enhanced), Tuition Reimbursement, Paid Time Off, Employee Health and Wellness
and access to day care services at Bright Horizons Midtown Detroit, and a whole host of other
benefits and services.
Equal Employment Opportunity/Affirmative Action Employer
Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health System is
committed to the hiring, advancement and fair treatment of all individuals without regard to
race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,
weight, marital status, family status, gender identity, sexual orientation, and genetic information,
or any other protected status in accordance with applicable federal and state laws.