Manager of Data Management

HCA Healthcare•Nashville, TN

About The Position

Introduction Are you passionate about the patient experience? At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like family! Jump-start your career as a Manager of Data Management today with HCA Healthcare. Benefits HCA Healthcare offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include: Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. Free counseling services and resources for emotional, physical and financial wellbeing 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service) Employee Stock Purchase Plan with 10% off HCA Healthcare stock Family support through fertility and family building benefits with Progyny and adoption assistance. Referral services for child, elder and pet care, home and auto repair, event planning and more Consumer discounts through Abenity and Consumer Discounts Retirement readiness, rollover assistance services and preferred banking partnerships Education assistance (tuition, student loan, certification support, dependent scholarships) Colleague recognition program Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence) Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income. Learn more about Employee Benefits Note: Eligibility for benefits may vary by location. Come join our team as a Manager of Data Management. We care for our community! Just last year, HCA Healthcare and our colleagues donated 13.8 million dollars to charitable organizations. Apply Today! Job Summary and Qualifications The Manager of Data Management's primary function is to analyze new plan documents and perform benefit coding to load benefits using a table based computer claims system. This position will also be responsible for loading and maintaining other system control files to support claims processing, membership, provider and authorization processing, and to oversee and manage the Electronic Claims System, ACO/PPO Eligibility, & Excelicare staff, and Provider Database staff.

Requirements

Demonstrated analytical skills with ability to review information to determine appropriate action and define and resolve problems
Deep understanding of health plan benefits coding
Excellent written and verbal communication skills
Computer skills capable of running batch processes on mainframe system and managing data files and running batch process on PC environment
In depth knowledge of health care industry
Demonstrated ability with PC software
Ability to maintain documentation in format, which is easily understood by users Knowledge in MS Access and MS Excel
Firm understanding of claims systems and claims process
Bachelor's Degree or equivalent work experience required
Four years of experience required
Experience loading/updating benefit plans and health plan contracts
Claims experience and/or strong knowledge of claims processes

Responsibilities

Oversee the coordination with Health Plans for the receipt for new plan documents
Implement new plan documents using table based computer system
Analyze benefit categories and adjudication rules to create new benefit types
Maintain benefit category, plan coding and data values in system for all lines of business and all business entities
Manage the process of running jobs on computer system to upload data, research, correct and post data to computer system
Interfaces with multiple departments and technical staff for system implementation issues and changes
Manage the implementation of provider data in multiple systems
Analyze provider contracts and input provider pricing into table based computer system
Manage yearly CMS rate change implementation and validation
Direct the process of inputting of pricing schedules into system
Research and resolve member file, provider file, plan coding and pricing issues
Performs systems testing when updates and/or new releases are made to the computer system
Conducts training session for users
Keep IT informed of system and operational issues
Manage the Electronic Claims processing staff
Maintain the Electronic Funds Transfer system implementation
Manage the AS400 implementation of new claims business (plans, providers, DOFR, fee schedules)
Maintain the Finance Recovery Table for internal Healthplan billback process
Maintain the Provider Override Table in Access Express for Utilization Management for authorization purposes
Manage the Excelicare and Encounter staff
Manage AS400 system changes and updates
Perform other duties as assigned

Benefits

Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
Free counseling services and resources for emotional, physical and financial wellbeing
401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
Employee Stock Purchase Plan with 10% off HCA Healthcare stock
Family support through fertility and family building benefits with Progyny and adoption assistance.
Referral services for child, elder and pet care, home and auto repair, event planning and more
Consumer discounts through Abenity and Consumer Discounts
Retirement readiness, rollover assistance services and preferred banking partnerships
Education assistance (tuition, student loan, certification support, dependent scholarships)
Colleague recognition program
Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.