Manager, Provider Svcs Systems at TriWest Healthcare Alliance in Phoenix, Arizona

Job Description:

Veterans, Reservists, Guardsmen and military family members are encouraged to apply!!

We offer remote work opportunities (AK, AR, AZ, CA, *CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TX, UT, VA/DC, *WA, WI & WY only)

Job Summary

Reporting directly to the Director, Provider Data & Management, this position is responsible for oversight of the provider services systems, quality, training and documentation processes that support the operations of the Provider Services department. Represents Provider Services in related process redesign and quality projects aligned to the annual strategic plan. Leads or participates in improvement projects, performs cost/benefit analysis. Executes projects from start to finish. Initiates joint problem-solving using data analysis tools, performance measurements, and decision-making processes. Coordinates the integration of office operations and on-line systems. Assists with staff training and developing staff to attain service-level requirements of the TriWest business and ensures compliance with TriWest policies and procedures. Oversees implementation of system enhancement implementation and coordinates schedules and communications with department leaders within the organization.

Education & Experience

Required:

• Bachelor's degree in Business, Communications, or related field or equivalent work experience
• 3+ years Provider data management experience
• 3+ years supervisory or leadership experience (e.g. project manager)
• Experience in training, planning, leading, and participating in major process improvement projects

Preferred:

• Experience with Apptus or other contract management system
• Experience in management/supervision of staff in a managed care environment
• Knowledge of government programs administered by TriWest

Key Responsibilities

• Manages most provider services systems, provides version control, and overall administration of system security within Provider Services.
• Initiates and manages the change order process for Provide Services and coordinates with network subcontractors ensuring adherence to implementation schedules.
• Ensures compliance with contract requirements and reporting of service levels within Provider Services.

• Designs and manages quality assurance and training programs to improve operational performance. Develops ongoing metrics and monitoring processes to assess effectiveness and efficiency for continuous improvement. Identifies staff development needs and recommends training plans.
• Plans and designs performance systems supported by benchmarking, cost analysis, business cases, and other criteria.
• Participates in the implementation of systems designed to measure process and performance. Contributes to program governance, project reviews, cross-functional communications and training.
• Collaborates with TriWest management team to identify service issues and develop enhanced metrics. Contributes to quality projects.
• Evaluates case reviews to identify and address quality and service improvement opportunities. Serves as a change agent to promote the development and integration of systems-thinking, customer focus, and commitment to continuous process improvement.

.:

• Creates active change by facilitating issue identification, research, and cross-functional corrective action.
• Partners cross-functionally to promote high-quality service levels throughout TriWest.
• Develops and manages effective training to drive continual quality improvement to cultivate a high performance workforce.
• Manages daily operational resources, tracking results against requirements.
• Oversees department staff, assigning and monitoring workflow.
• Delivers on-the job training and remedial coaching.
• Participates in special projects and meetings.
• Performs other duties as assigned.
• Regular and reliable attendance is required.

Competencies

Communication / People Skills: Ability to influence or persuade others under positive or negative circumstances; adapts to different styles; listens critically; collaborates.

Coping / Flexibility: Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach is required.

Independent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources.

Leadership: Successfully manages different styles of employees; provides clear direction and effective coaching.

Multi-Tasking / Time Management: Prioritizes and manages actions to meet changing deadlines and requirements within a high volume, high stress environment.

Problem Solving / Analysis: Ability to solve problems through systematic analysis of processes with sound judgment; has a realistic understanding of relevant issues.

Team-Building / Team Player: Influences the actions and opinions of others in a positive direction and build group commitment.

Technical Skills: Knowledge of TriWest administered programs, quality assurance programs, instructional design, needs analysis, and post-implementation measurements, quality tools and models; experience with data management, statistical analysis, performance measurement and monitoring, report design, presentation, and meeting facilitation; experience with database software, Excel, Project, PowerPoint, Access, Visio, and other statistical tools.

Working Conditions

Working Conditions:

• Works within a standard office environment, travel may be required
• Extensive computer work with long periods of sitting

Company Overview

Taking Care of Our Nation's Heroes.

It's Who We Are. It's What We Do.

Do you have a passion for serving those who served?

Join the TriWest Healthcare Alliance Team! We're On a Mission to Serve®!

Our job is to make sure that America's heroes get connected to health care in the community.

At TriWest Healthcare Alliance, we've proudly been on that important mission since 1996.

Benefits

We're more than just a health care company. We're passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes:

• Medical, Dental and Vision Coverage


• Generous paid time off


• 401(k) Retirement Savings Plan (with matching)


• Short-term and long-term disability, basic life, and accidental death and dismemberment insurance


• Tuition reimbursement


• Paid volunteer time

*Annual base salary for Colorado and Washington State residents: $66,000 - $85,000 depending on experience*

Equal Employment Opportunity

TriWest Healthcare Alliance is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success. To that end, TriWest strives to create an inclusive environment that cultivates and supports diversity at every organizational level, including hiring and retaining a diverse workforce, and we highly encourages candidates from all backgrounds to apply. Applicants are considered for positions without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws.

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