Medicaid Manager

Location: Cincinnati, Ohio
Date Posted: 11-09-2017
Position Title          Medicaid Manager #3951
 
Relocation               No
 
Location                  Cincinnati Area
 
Position Summary: Primarily responsible leadership and management of the Medicaid Department.
 
General Purpose: Leadership; problem resolution; critical thinking; auditing; relationship and team building; process development and improvement
 
Essential Duties and Responsibilities:
*           Work with Human Resources staff to recruit, interview, select and hire for the Medicaid Department.
*           Coach, mentor and develop staff, including overseeing new employee onboarding and providing development and education opportunities for the Medicaid Department.
*           Lead employees to meet the organization's expectations for productivity, quality, and goal achievement.
*           Plan and allocate resources to appropriately staff each assignment.
*           Evaluate and improve departmental operating procedures to enhance speed, quality, efficiency and financial results.
*           Review performance data to monitor and measure departmental productivity, goal achievement, and overall effectiveness.
*           Review insurance contracts and Medicaid Provider Manuals to gain thorough understanding of payment methodologies.
*           Examine claims and calculate reimbursement based on contract terms to determine accuracy of payment through use of various reports, electronic tools and supporting documentation.
*           Contact insurance company to obtain missing information, explain and resolve underpayments and/or denials and arrange for payment or adjustment processing on behalf of client.
*           Prepare and submit correspondence such as letters, emails, online inquiries, appeals, adjustments, reports and payment posting.
*           Maintain regular contact with necessary parties regarding project status including payors, clients, managers, and other company personnel.
*           Build strong, lasting relationships with clients, payors and company personnel.
*           Organize, prepare and/or attend department, client and company meetings.
*           Comply with federal and state laws, company policies and procedures.
 
Essential Skills and Experience:
*           Minimum 5-years Management experience
*           Minimum 2-years Healthcare related experience
*           Excellent interpersonal skills with proven ability to motivate and lead a team
 
 
Bottom line requirements we need notes on with candidate submittal:
 
1.  5+ years of Management experience.
2.  2+ years of Medicaid related experience
3.  Strong communications and presentation skills.
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