CFHP

University Health Systems   San Antonio, TX   Full-time     Management
Posted on January 25, 2023
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University Health System is where professionals have career-validating experiences.  We are a nationally-recognized academic medical center, a Level I Trauma Center and the primary partner of UT Medicine San Antonio.

University Health System has again been named one of the nation's Most Wired Hospitals and Health Systems. This is our eighth time on the list, which recognizes use of technology by healthcare systems.

Job Duties

This position is responsible for managing, implementing, and executing key projects and reporting requirements specific to the Medicare Advantage (MA) and Dual Special Needs Plans (D-SNP).

The Senior Manager, Medicare Plans requires a unique skill set that includes working with cross-functional leaders on complex projects, collaborating throughout internal and external organizations, understanding workflow, and creating an efficient, productive environment to work effectively throughout the organization to ensure successful alignment of the Medicare Advantage operational goals. 

Develops resource management tools to schedule work, monitor progress, and report status.

Manages assigned program tasks and monitors Health Plan Management System (HPMS) and Centers for Medicare & Medicaid Services (CMS) websites for reporting requirements, instructional guides, announcements, and deliverables.

Coordinates with the Compliance department on all HPMS/CMS deliverables.

Assists with specific Health Outcomes Survey strategies in collaboration with partners in STARS, Risk Adjustment, and Care Management teams.

Implement data-driven efficiencies for addressing gaps, and drive implementation and usage of record exchange through SFTP site transfers and HPMS/CMS website access.

If you are looking to take your career to the next level, this is the opportunity for you.  We offer an excellent benefit and compensation package.  

Requirements

  • Bachelor’s degree required; Master’s degree in Health Care Administration, Business Administration or a related field preferred.
  • Minimum of five (5) years relevant experience required.
  • Experience in managing Medicare related projects/processes.
  • Extensive knowledge of Medicare Managed Care rules and regulations required.
  • Proven experience using analytical/statistical reporting software for evaluation and data analysis.
  • Must exhibit thorough understanding of NCQA standards and regulatory requirements.

Licensure

Not a requirement for this position however, if a Registered Nurse, must be licensed in the State of Texas.