29 days old

PACE Life Director of Analytics

AtlantiCare Regional Medical Center
Atlantic City, NJ 08401
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  • Job Code
    112962301
AtlantiCare Regional Medical Center

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.


Atlantic City, NJ

POSITION SHIFT: Days

POSITION STATUS: Full-Time

REQ_NUM: 04-24245

Department: PACE-Life Connection

Hours Per Week 40

Holidays Required? No

Job Category: Administration/Customer Service

Location: Atlantic City

Weekends Required? No


Minimum Qualifications:
  • Master's degree or equivalent in Accounting, Finance, or related business field required.
  • Minimum 1 year experience in working with the frail or elderly population required.
  • Minimum of seven (7) years of experience in the healthcare/managed care industry.
  • Significant knowledge of contractual, administrative, healthcare and operational issues related to managed care organizations, CMS/Medicare Part D plan, physician groups, hospitals and/or health insurance benefit plan designs required.
  • Experience completing financial statements and budgets in a complex, multi-disciplinary organization required.

POSITION SUMMARY

Serves on the LIFE Connection management team and provides oversight for LIFE Connection finance staff. Works with team members to lead risk based revenue process improvements, accomplish overall financial planning, budgeting, accounting and reporting of all monetary transactions and revenue/expense cycles for nonprofit health system affiliates in compliance with State, Federal, and G.A.A.P. guidelines.

Has responsibility for initiating and sharing analyses of financial performance and the impact of potential strategic initiatives. Oversees revenue/expense cycles of AtlantiCare LIFE Connection while maintaining compliance with all internal controls. Financial analysis of revenue and expense projections including service utilization and other parameters. Analyze& monitor financial aspect of existing or need for new provider contracts.

The Director of Revenue Cycle also monitors authorization and the claims management process for auditing and process improvement purposes. This position also have oversight for the Development and auditing of provider fee schedules. Maintain and distribute provider network participation and development re: signed contracts; contracts under negotiation or plans to not negotiate with provider.

In coordination with the Medical Director, Responsible for the development with applicable consultants the Part D Bid submission and reporting to CMS

In conjunction with the LIFE Connection Leadership team, prepares budgets for entities and submits to the respective committees, boards, and governmental agencies in the required format.

Makes cost-savings suggestions related to all operations and implement once approved.

Maintain LIFE Connection client Medicare/Medicaid eligibility/plan membership

This position supports organizational goals by providing quality customer service, participating in performance improvement efforts and demonstrating a commitment to team work and cooperation.

QUALIFICATIONS

EDUCATION: Master's degree or equivalent in Accounting, Finance, or related business field required.

LICENSE/CERTIFICATION:

EXPERIENCE: Minimum of seven (7) years of experience in the healthcare/managed care industry. Minimum 1 year experience in working with the frail or elderly population required.

Significant knowledge of contractual, administrative, healthcare and operational issues related to managed care organizations, CMS/Medicare Part D plan, physician groups, hospitals and/or health insurance benefit plan designs required. Experience completing financial statements and budgets in a complex, multi-disciplinary organization required.

PERFORMANCE EXPECTATIONS

Demonstrates the competencies as established on the Assessment and Evaluation Tool for this position.

WORK ENVIRONMENT

This positon must be able to work effectively within an interdisciplinary team model, interfacing and collaborating with a wide range of clinical and social services disciplines who work together to manage the PACE participants' care. The work setting is in an Adult Day Health Center and primary care clinic environment with moderate noise levels and controlled temperatures.

This position also requires corrected vision and hearing to normal range. Incumbents must be able to communicate with all staff, vendors, and clients. Requires manual and finger dexterity and eye-hand coordination; the ability to use department equipment. This position also requires lifting/carrying up to 65lbs.and pushing or pulling 150lbs.using appropriate body mechanics and equipment, with reasonable accommodation if needed.

REPORTING RELATIONSHIP

This positions reports to department leadership.

The above statement reflect the general details considered necessary to describe the principle functions of the job as identified and shall not be considered as a detailed description of all work requirements that may be inherent in the position.

PI112962301

<b>AtlantiCare Regional Medical Center</b><br/><br/>All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.<br/><br/><br/>Atlantic City, NJ<br/><br/><b>POSITION SHIFT: </b>Days<br/><br/><b>POSITION STATUS: </b>Full-Time<br/><br/><b>REQ_NUM: </b>04-24245<br/><br/><b>Department: </b>PACE-Life Connection<br/><br/><b>Hours Per Week </b>40<br/><br/><b>Holidays Required? </b>No<br/><br/><b>Job Category: </b>Administration/Customer Service<br/><br/><b>Location: </b>Atlantic City<br/><br/><b>Weekends Required? </b>No<br/><br/><br/><STRONG>Minimum Qualifications</STRONG>:<br><UL><LI>Master's degree or equivalent in Accounting, Finance, or related business field required.</LI><LI>Minimum 1 year experience in working with the frail or elderly population required.</LI></UL><UL><LI>Minimum of seven (7) years of experience in the healthcare/managed care industry.</LI></UL><UL><LI>Significant knowledge of contractual, administrative, healthcare and operational issues related to managed care organizations, CMS/Medicare Part D plan, physician groups, hospitals and/or health insurance benefit plan designs required.</LI><LI>Experience completing financial statements and budgets in a complex, multi-disciplinary organization required.</LI></UL><br><STRONG>POSITION SUMMARY</STRONG><br><br>Serves on the LIFE Connection management team and provides oversight for LIFE Connection finance staff. Works with team members to lead risk based revenue process improvements, accomplish overall financial planning, budgeting, accounting and reporting of all monetary transactions and revenue/expense cycles for nonprofit health system affiliates in compliance with State, Federal, and G.A.A.P. guidelines.<br><br>Has responsibility for initiating and sharing analyses of financial performance and the impact of potential strategic initiatives. Oversees revenue/expense cycles of AtlantiCare LIFE Connection while maintaining compliance with all internal controls. Financial analysis of revenue and expense projections including service utilization and other parameters. Analyze& monitor financial aspect of existing or need for new provider contracts.<br><br>The Director of Revenue Cycle also monitors authorization and the claims management process for auditing and process improvement purposes. This position also have oversight for the Development and auditing of provider fee schedules. Maintain and distribute provider network participation and development re: signed contracts; contracts under negotiation or plans to not negotiate with provider.<br><br>In coordination with the Medical Director, Responsible for the development with applicable consultants the Part D Bid submission and reporting to CMS<br><br>In conjunction with the LIFE Connection Leadership team, prepares budgets for entities and submits to the respective committees, boards, and governmental agencies in the required format.<br><br>Makes cost-savings suggestions related to all operations and implement once approved.<br><br>Maintain LIFE Connection client Medicare/Medicaid eligibility/plan membership<br><br>This position supports organizational goals by providing quality customer service, participating in performance improvement efforts and demonstrating a commitment to team work and cooperation.<br><br><STRONG>QUALIFICATIONS</STRONG><br><br><STRONG>EDUCATION: </STRONG>Master's degree or equivalent in Accounting, Finance, or related business field required.<br><br><STRONG>LICENSE/CERTIFICATION:</STRONG><br><br><STRONG>EXPERIENCE: </STRONG>Minimum of seven (7) years of experience in the healthcare/managed care industry. Minimum 1 year experience in working with the frail or elderly population required.<br><br>Significant knowledge of contractual, administrative, healthcare and operational issues related to managed care organizations, CMS/Medicare Part D plan, physician groups, hospitals and/or health insurance benefit plan designs required. Experience completing financial statements and budgets in a complex, multi-disciplinary organization required.<br><br><STRONG>PERFORMANCE EXPECTATIONS</STRONG><br><br>Demonstrates the competencies as established on the Assessment and Evaluation Tool for this position.<br><br><STRONG>WORK ENVIRONMENT</STRONG><br><br>This positon must be able to work effectively within an interdisciplinary team model, interfacing and collaborating with a wide range of clinical and social services disciplines who work together to manage the PACE participants' care. The work setting is in an Adult Day Health Center and primary care clinic environment with moderate noise levels and controlled temperatures.<br><br>This position also requires corrected vision and hearing to normal range. Incumbents must be able to communicate with all staff, vendors, and clients. Requires manual and finger dexterity and eye-hand coordination; the ability to use department equipment. This position also requires lifting/carrying up to 65lbs.and pushing or pulling 150lbs.using appropriate body mechanics and equipment, with reasonable accommodation if needed.<br><br><STRONG>REPORTING RELATIONSHIP</STRONG><br><br>This positions reports to department leadership.<br><br><STRONG>The above statement reflect the general details considered necessary to describe the principle functions of the job as identified and shall not be considered as a detailed description of all work requirements that may be inherent in the position.</STRONG><br/><br/> <img src="https://analytics.click2apply.net/v/m6opwXubroX5CKlqs4wpZ"> <p>PI112962301</p>
Posted: 2019-08-20 Expires: 2019-09-21

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PACE Life Director of Analytics

AtlantiCare Regional Medical Center
Atlantic City, NJ 08401

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