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Manager of Support Services - Claims

Company: Christus Health
Location: Irving
Posted on: April 16, 2019

Job Description:

Description
The Operations Support Manager oversees the consolidated support assets of the functions within CHRISTUS Health Plan Operations. Reporting to the Chief Operating Officer, these functions include Claims, Configuration, Enrollment, the Call Center, and Appeals and Grievances. With a focus on audit, other support roles of the function include training, business analytics, and recruiting. Managerial responsibilities include managing auditors, trainers, business analysts, consultants, recruiting entities (internal and external), and project teams. Work involves managing and supervising operational and compliance audit projects; managing training of new and existing Operations staff (onboarding and periodic training); managing business analyses; managing recruiting activities for the Operations function; providing consulting services to organizational management and staff.



The Operations Support Manager works independently with extensive latitude for initiative and independent judgment. Directs appropriate levels of management to implement effective business solutions, improve information systems infrastructure, and share knowledge to enhance service, technical quality and regulatory compliance. Monitors outstanding issue status on an ongoing basis to ensure timely and appropriate resolution. Interfaces with senior management and governance potentially in geographically dispersed regions to strengthen internal controls, educate and to address strategic management vision, issues and risks. Supervises staff to broaden their experience and to develop their ability to handle more complex audits/projects. Coordinates activities with other internal and external providers, including the external auditors, to ensure proper coverage and minimal duplication of effort.

MAJOR RESPONSIBILITIES

Related to Leadership and Management:

Develops and maintains productive client, staff and management relationships through individual contacts and group meetings.
Enhances processes and procedures to ensure auditors implement and execute automated control reviews into audit plans and support the integration of internal/external audit activities to achieve efficiencies and service improvement.
Represents internal audit on organizational project teams, at management and board meetings and with external organizations.
Prepares and presents technical presentations to external and internal audiences.
Interfaces with senior management and governance to strengthen internal control and provide formal and informal education.
Facilitates effective communication with leadership, direct reports and associates to ensure the objectives of the function are achieved in a manner consistent with the mission and core values.
Creates and maintains a work environment consistent with the CHRISTUS Vision of the Workplace and establishes work norms for staff and external contacts to work effectively in a professional team environment.
Performs related work as assigned by the CHP Chief Operating Officer

Related to Human Resource Management and Development:

Develops an effective Operations Support team (including audit, training, business analytics, recruiting) to include appropriately skilled professionals, ensuring job development progression; conducting staff evaluations, coaching and supporting Associates to achieve high levels of productivity and achievement of objectives.
Develops the Operations Support staff to ensure expertise in conducting interviews, reviewing documents, developing and administering surveys, composing summary memos and preparing working papers.
Identifies education requirements and opportunities that support an integrated and flexible Operations Support function.
Pursues professional development opportunities, including external and internal education and professional association memberships and shares information gained with co-workers.


Related to Operations Support:

Audit: Oversees the conduct of daily audits within supported functions. Oversees the creation and application of each supported function's Individual and Departmental Metrics. Assists in planning periodic operational audits in conjunction with auditors, across supported functions. Coordinates with internal and external parties (consultants, auditors, regulators) to facilitate the conduct of audits with a focus toward limiting business interruption.
Recruiting: Facilitates, speeds, and improves the quality of the existing recruiting infrastructure at CHRISTUS. Works with supported functional leads and internal and external recruiters to fill staff needs in a proactive manner with quality candidates. Plans recruiting needs with the functional needs in advance on a quarterly basis. Coordinates candidate interviews with recruiting staff. Conducts or coordinates screenings: resume reviews and initial screens for the supported functions. Collects interview feedback and facilitates hire/no hire decision making with functional leadership. Coordinates offers as appropriate.
Training: Oversee creation and documentation of training processes/manuals for new hires within each function. Oversee development of new training for process/technology changes. Monitor and evaluate training across function (tie to daily audit performance)
Business Analytics: Provide support to the Operations Support Business Analyst resource(s) including:

Administrative support
Cross functional insights




Requirements
Undergraduate business related degree from an accredited college or university is required.
An advanced degree in business administration, healthcare management, public administration or related field is desired.
Knowledge of and skill in applying internal auditing, management principles and preferred business practices.
Demonstrated knowledge of and skill in applying industry program policies, procedures, regulations and laws, such as Medicare and other government payors.
Knowledge of management information systems terminology, concepts and practices.
Ability to evaluate and apply the International Standards for the Professional Practice of Internal Auditing, Code of Ethics, and the Practice Advisories developed by The Institute of Internal Auditors.
Demonstrated skill in collecting and analyzing complex data and processes, evaluating information and systems and drawing logical conclusions.
Highly skilled in planning, project management, prioritization of multiple activities, and in maintaining composure under pressure while meeting multiple deadlines.
Ability to negotiate and resolve issues.
Skilled with all aspects of office automation (spreadsheets, word processing, electronic mail, project management, and presentation software).
Ability to effectively communicate and present orally and in writing, including being an active listener.
Ability to learn new operations quickly and work independently.
Ten years of experience to including audit and some or all of training, business analytics, and recruiting across call center, claims, enrollment, appeals/grievances, and/or configuration functions.
Managed Care experience two to four years
Experience in an integrated healthcare delivery system, or equivalent, is preferred.

Keywords: Christus Health, Irving , Manager of Support Services - Claims, Executive , Irving, Texas

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