Government Programs Operations Administrator - Health Alliance Plan - Troy
Under minimal supervision, the Medicare Programs Administrator will perform various operational activities (enrollment and/or reconciliation activities) related to the Medicare Advantage, Medicaid, and Health Care Reform operations for the contracts held by HAP and Alliance Health & Life Insurance Company (AHL) with the Centers of Medicaid and Medicare (CMS). Project work may include technical analyses or may require facilitation of a large multi-disciplinary group of senior administrators and/or medical leaders. Design, document and update complex business models related to Government Business Operations. Manage and support major system initiatives to ensure that assigned projects are produced and delivered on schedule and within budget and meet or exceed quality standards. Train HAP employees directly or indirectly that are responsible for Operations and Compliance related activities.
PRINCIPAL DUTIES AND RESPONSIBILITES:
- Conducts review of organization and functional areas on a project basis; acts as project lead for individual or team projects
- Project management activities, including but not limited to effective implementation of both Advantasure Medicare Gateway related interfaces and Medicaid Enrollment System, development of an infrastructure to support project initiatives, process workflows, relevant and meaningful data reporting and analysis, in addition to the timely and accurate migration of Advantasure Medicare Gateway and Medicaid Enrollment System enhancements.
- Data reporting, analysis, trending and project management activities for the Enrollment & Claims division that includes responsibilities focused on the following divisional segments: Enrollment & Billing (Commercial, Medicare and Medicaid).
- Documents current systems and operations.
- Analyzes client systems, procedures, and operations and identifies opportunities for improvement AND more...