Operations Manager, Health Economics & Info

Metropolitan Jewish Health System•New York, NY

11d

About The Position

The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms. The MJHS Difference At MJHS, we are more than a workplace; we are a supportive community committed to excellence, respect, and providing high-quality, personalized health care services. We foster collaboration, celebrate achievements, and promote fairness for all. Our contributions are recognized with comprehensive compensation and benefits, career development, and the opportunity for a healthy work-life balance, advancement within our organization and the fulfillment of having a lasting impact on the communities we serve.

Requirements

Bachelor's Degree in Statistics, Economics, Business or other related field required.
5 years experience in Healthcare Economics, Statistics, Data Analysis, Financial Reporting, Actuary, Managed Care, and/or Long Term Care operations experience required.
Medicare and/or Medicaid Managed Care experience required.
Experience with regulatory reporting required.
Excellent organizational skills.
Ability to work on multiple projects.
Excellent Word, Excel, Access, Project, Visio skills.
Excellent SQL Server 2008R2 (or better) skills with Reporting Services preferred.

Nice To Haves

Graduate Degree (MBA or CPA) in Statistics, Healthcare, Economics or Business preferred.
Knowledge of CMS & NYS DOH regulations preferred.
Experience calculating IBNR, BCR (Benefic Cost Ratios) and other metrics preferred.
Experience formulating MMCOR and encounter data preferred.
Experience developing rate filings including Medicare Advantage Part C & D and MLTC preferred.
Management experience preferred.

Responsibilities

The manager will coordinate multiple projects, oversee day-to-day staffing, and administer all standard operating procedures. Operational Data Store
Under guidance of Director, oversee project management for all operational data store activities.
Work closely with Analysts to create new functional specifications for enhancements or to improve existing logic based on changing business needs.
Owner of change control process and documentation for each approved modification.
Oversee test plan development, documentation and implementation process.
Oversee creation of training documentation for new or updated designs for day-to-day data usage.
Under guidance of Director and in collaboration with business owners, manage projects and prioritize all new reporting needs for daily on-demand and auto-delivered data.
Oversee peer review process, ensuring quality and accuracy standards are met.
Identify ad-hoc reporting that can be converted to standardized reporting for enhanced automation and increased efficiency.
Recommend technological enhancements for improved standardized reporting.
Obtain functional requirements from business users on how they want to monitor staff productivity. Prepare confidential reports to fulfill this need.
Time extracts and reports to oversee the length of time required for each. Merge with overall system performance metrics to provide recommendations to senior leadership.

Benefits

Tuition Reimbursement for all full and part-time staff
Generous paid time off, including your birthday!
Affordable and comprehensive medical, dental and vision coverage for employee and family members
Two retirement plans! 403(b) AND Employer Paid Pension
Flexible spending
Employee and family health coverage
Competitive salaries
Employer contributed pension plan
Generous time off
Tuition reimbursement
403(b) retirement plan