Data Processing Operations Manager

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POST DATE 8/18/2016
END DATE 10/17/2016

Chickasaw Nation Industries Rockville, MD

Company
Chickasaw Nation Industries
Job Classification
Full Time
Company Ref #
95094396
AJE Ref #
575913381
Location
Rockville, MD
Job Type
Regular

JOB DESCRIPTION

APPLY
The Data Processing Operations Manager provides support to the Centers for Medicare & Medicaid Services (CMS) Payment Error Rate Measurement (PERM) program. This position conducts state Data Processing orientations, develops review schedules, and is responsible for the assignment of review team staff. The Data Processing Operations Manager supports the PERM Data Processing task area through the preparation and monitoring of reports, participation in meetings, and serves as a point of escalation for complex issues.

ESSENTIAL DUTIES AND RESPONSIBILITIES
Essential duties and responsibilities include the following. Other duties may be assigned.

Responsible for the integration of CNI Core Competencies into daily functions, including: commitment to integrity, knowledge / quality of work, supporting financial goals of the company, initiative / motivation, cooperation / relationships, problem analysis / discretion, accomplishing goals through organization, positive oral / written communication skills, leadership abilities, commitment to Affirmative Action, reliability / dependability, flexibility and ownership / accountability of actions taken.

Serves as subject matter expert (SME) for PERM Data Processing review team.

Conducts data processing State Orientation meetings in conjunction with the Cycle Manager.

Works with the Cycle Manager to determine state readiness for initiation of PERM review.

Creates review schedules and determines review team assignments.

Provides oversight for the development of review procedures and desk aids.

Prepares and monitors data processing reports, taking appropriate action as required.

Performs multi-level data processing reviews as business needs dictate.

Monitors staff performance and provides timely feedback.

Collaborates with the Regulation and Policy Manager to identify and incorporate regulation changes into data processing review process.

Assists state lead with issue resolution and serves as a point of escalation.

Provides onsite support and oversight as business needs dictate.

Recommends enhancements to PERM project technology and participates in business requirements sessions.

Actively participates in internal and external meetings providing data processing subject matter expertise and recommendations.

Performs Human Resource functions including but not limited to hiring, performance evaluation, and disciplinary actions up to and including termination.

Maintains the confidentiality of patient information in accordance with HIPAA regulations.

Collaborates with the Administrative Specialist for staff travel arrangements.

Responsible for aiding in own self-development by being available and receptive to all training made available by the company.

Plans daily activities within the guidelines of company policy, job description and supervisor's instruction in such a way as to maximize personal output.

Responsible for keeping own immediate work area in a neat and orderly condition to ensure safety of self and coworkers. Will report any unsafe conditions and/or practices to the appropriate supervisor and human resources. Will immediately correct any unsafe conditions to the best of own ability.

EDUCATION/EXPERIENCE
Bachelor's degree and a minimum of ten (10) years relevant experience, or equivalent combination of education / experience.
Master's degree preferred. Work experience may be substituted at a rate of two years per one year of formal education. Experience working as a client facing manager within a Medicaid or other health insurance claims environment is preferred.

JOB SPECIFIC KNOWLEDGE / SKILLS / ABILITIES
Knowledge of Medicaid programs and Medicaid Management Information Systems (MMIS)
Proficient in Microsoft Office Suite, in particular Word, PowerPoint, Excel and Outlook
Excellent project management skills relative to all aspects of planning, organizing and coordinating the project with stakeholders
Strong analytical skills with the ability to collect, organize, evaluate and disseminate significant amounts of information
Excellent communication and interpersonal skills
Demonstrated time-management and organizational skills
Attentive to detail and accuracy
Demonstrated technical expertise
Ability to adapt communications depending on the audience, both technical and non-technical
Ability to work well in both a team and independent environment
Ability to work with senior level internal and external stakeholders
Ability to collect and analyze complex data, both narrative and statistically
Ability to adapt to stressful environments and to utilize problem-solving skills in a demanding environment

CERTIFICATES, LICENSES, REGISTRATION

MATHEMATICAL SKILLS
Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference and volume. Ability to apply concepts of basic algebra and geometry.

REASONING ABILITY
Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

LANGUAGE SKILLS
Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.

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