Systems Coordination Claims Supervisor

HealthPartners•Bloomington, MN

About The Position

HealthPartners is hiring a System Coordination Claims Supervisor. This position supervises the project coordinators in the development, revision, or maintenance of Claims systems, coordinating the activities of all affected departments. Responsible for effective systems design and maintenance, with scope including operational and administrative areas. Provides CQI facilitation, consulting and technical assistance regarding systems to Group Division, Contracting and Finance staff. Liaison with staff from Information Services, Finance, Patient Accounting, Membership Accounting, Network Management, Sales Marketing and Electronic Commerce. Provides the guidance, motivation, and support necessary to enable individual growth and teamwork in line with the individual needs, department objectives, and marketplace expectations.

Requirements

Bachelor’s degree in health care management, training and organization development, industrial engineering, business administration, computer science or related field, or equivalent experience.
One-year professional level experience with mainframe computer systems may be substituted for college level computer science or data processing course work.
4+ years general business experience or experience in medical insurance or health care setting, including significant project planning and people management experience with medium to complex level projects.
Ability to interact with all levels of HealthPartners staff and external customers
Strong interpersonal and human relations skills.
Ability to lead others through change and to be flexible and adaptive to changes; ability to make immediate adjustments to work direction.
Familiarity with continuous improvement concepts and methodologies.
Demonstrated analytical, facilitation, presentation and communication skills.
Ability to deal with ambiguity and changing priorities.
Strong customer/client service orientation.
Able to take responsibility for one’s own performance and attitude on the job.
High degree of initiative.
Demonstrate effectiveness in evaluating employees and giving feedback.
Ability to identify training needs and provide learning opportunities.
Strong organizational and time management skills

Responsibilities

Responsible for the supervision of staff, including having the authority to hire, transfer, lay off, promote, discipline and discharge, train, reward and review performance of employees. Ensures compliance to organizational and departmental policies and procedures.
Ensure, direct, and/or provide the training of staff, both permanent and temporary to the Claims Department while promoting teamwork and encourage high levels of morale and motivation.
Serve as primary contact for the organization to the Claims System Benefit and Pricing team. Attend management meetings as necessary and appropriate, to develop partnerships with claims and health plan operations leaders.
Create high performance work teams using performance measurements, individual goal setting, and monitoring and evaluation of results.
Work with staff to develop and implement goals and objectives both individual and for the department.
Identify staff performance issues and prepare and implement action plans to resolve problems
Skillfully represent the Claims Department at inter-department meetings by building relationships, communicating effectively, demonstrating confidence, and balancing department and company interests.
Identifies and researches problems, implements or recommends solutions depending on the scope of the problem. Proactively seeks out process and system enhancements to maximize efficiency and member experience.
Project Team Leader. Serves as project team leader with responsibility for analyzing, organizing, scheduling and directing projects as assigned. Responsible for project completion within expected time. Responsible for design, testing, and maintenance of systems. Prepare final documentation of methodology, findings, and recommendations of project team for management. Facilitates smooth transition of project to affected departments/units upon completion.
CQI Facilitator/Team Member. Receives formal training as a CQI facilitator. Identifies opportunities for quality improvement of processes. Facilitates CQI projects as appropriate when business process re-engineering is required prior to software changes. Serves as facilitator for claims CQI projects upon request, as availability permits. Represents department as a team member or consultant on CQI projects.
System design. On approved projects, works directly with information Systems supervisors and staff in development, maintenance or adaptation of program design. Claim department liaison with IS staff on software and hardware design issues.
Needs assessment. Through needs assessment and other processes, identifies potential enhancements in claims automated or manual system/processes. Evaluates systems enhancements for technical impact. Recommends system enhancements and implementation to supervisor/manager.
System expert. Assesses inter-dependencies among administrative systems, including membership, authorizations, and patient accounting, etc. Is a specialist in knowledge of claims systems and software.
Training and documentation coordination. Participates in the development of user documentation, processing and procedures.
Implementation and evaluation coordinator. Develops implementation plan and provides implementation tools to affected units/departments. Works with IS and Claims training to evaluate system design and implementation via-post-implementation review.
Initiator. Position requires a high degree of initiative, to manage priorities and identify opportunities for system improvement and innovation. Responsible for continued professional development.
Other duties. Performs other duties and assumes projects as assigned by manager or director.