MANAGER, PLAN ADMINISTRATION / IT MANAGER

MANAGER, PLAN ADMINISTRATION / IT MANAGER

Full-Time

Cleveland, Ohio

Summary 

Experienced manager for the team responsible for the design, entry, maintenance, testing and audit of plan designs for the adjudication of pharmacy transactions.  Ensures proper processes are in place to guide the consistent documentation and delivery with respect to the business needs.  Consistently demonstrates knowledge of managerial concepts, practices, and procedures through leadership of plan design resources.  Works effectively with several levels of management.  Solves problems and makes decisions independently but knows when to involve the appropriate management levels on more complex issues.

·  Plan design setup

·  Verification of appropriate loading of plan design components

·  Manager of Plan Administration must respond to questions regarding the impact of plan designs of adjudication of claims

·  Manager of Plan Administration must document plan design

·  Manager of Plan Administration must test plan design

·  Manager of Plan Administration must stay current on functionality needed to support the business

·  Support training on use of adjudication tools

-Responsibilities include providing work assignments, evaluating performance and conducting performance reviews, and making personnel decisions (i.e., hires, terminations, and salary changes).

-Provides input for department level process standards and budget constraints.

Essential Duties and Responsibilities  

·  Manages resources involved in various activities of plan design support.

·  Develops the team culture to show high regard for adherence to quality standards and operating at maximum efficiency.

·  Acts as a coach and mentor for specific technology and functional area.

·  Manages department performance and project related issues, which includes managing professional and behavioral skills of staff.

·  Facilitates status, performance, and career objective discussions, which includes conducting regular staff meetings.

·  Oversees compliance of department standards, project tracking, and organizational software development methodology.  May recommend or provide input to new department standards.

·  Develops processes and procedures to ensure department objectives are met.

·  Delivers comprehensive communications to senior management regarding the status and activities of the team both in written and presentation form.

Essential Skills / ExperienceExcellent communication skills (verbal and written) with the ability to interact effectively with others.Proven organizational planning skills.Demonstrated analytical and problem solving abilities.Proven experience coaching others for improved performance and career success.Demonstrated ability to identify and proactively address issues impacting team performance.Proven ability to influence the outcome of planned events to achieve desired future state.Proven ability to successfully manage multiple projects/tasks simultaneously.Experience with claims adjudication and healthcare transaction, preferably pharmacy.RxCLAIM experience is a plus.

 

EducationBachelor’s Degree in the appropriate discipline.8 or more years of experience in related discipline or function.2 or more years of management experience.