Medical Claims Program Director - Healthcare
Tracking Code
3664
Job Description This director position manages a group of accounts within the Managed Care Division under the supervision of a Senior Director, generating and managing annual revenues totaling between $5 – 8 million.
Position Responsibilities
* Preparation of and accountability to meet/exceed annual budget forecast
* Revenue strategy: Identify sources of revenue, prepare, monitor and achieve budget and revenue expectations for the group of accounts; forecast variations from budget on a weekly basis
* Manage internal and external 'subcontractors' in the delivery of program integrity projects
* For new services, work with client, account team and Senior Director to develop project approach and implementation plan; oversee development and implementation.
* Grow base contracts a minimum of 10% per year
* Report monthly progress against business goals to Senior Director
Operations Management
* Work closely with operations, including PMs, Subrogation, CAV, provider relations, etc. on the following:
Billing cycle scheduling, delivery and review, Disallowance processing, Cost avoidance policy management, including determining volumes of policies, quality standards, and frequency
Overpayment recovery services, Other client services projects
Client Management * Direct management of staff assigned to service the accounts; this may include supervision of Account Managers, Account Analysts and Systems Analyst ; indirect oversight of support staff in other divisions
Identify other client service needs that HMS can provide and, with support from Sales and Marketing, work with Senior Director to negotiate contract expansion to include these services
Ensure client satisfaction and achieve a 100% Client referral capability
Required Skills
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