Manager of Health Services Operations
This position supports the Integrated Care and Behavioral Health area of health services through oversight and organization of administrative efforts, including but not limited to, vendor relations, tracking, coordinating and management of implementation of new benefits; tracking of departmental and cross functional initiatives; liaises with appropriate support departments within Amida Care to facilitate projects and outcomes. Serves as a key point of contact for some regulatory related matters.
Essential functions are job duties and responsibilities that must be performed to accomplish the purpose/ goals of the job.
• Serves as behavioral health lead for management of coordination and implementation of Care Management System.
• Department point person for our Behavioral Health Vendor along with IC/BH leadership for tracking purposes.
• Partner with leadership to develop and document departmental workflows and related training materials. Provides staff training as needed.
• Oversee, coordinate and further develop and implement the Eligibility Verification process as well as being health services lead for Plan Initiated Disenrollment
• Provide support and/or coordination for various audits and/or plans of correction (such as Article 44/49 or IPRO coordination of care) in conjunction with appropriate vendors, internal departments, providers and other entities as needed.
• Lead process of behavioral health benefits management, by coordinating with appropriate staff and related/impacted vendors around benefit administration.
• Update and review Amida Care Benefit Guide/Grid related to Behavioral Health or other benefits under the area’s purview, in a timely manner. Ensure new benefits are implemented following all regulatory and Amida Care protocols. Responsible to review and ensure that Amida Care’s website reflects all necessary benefit and informational requirements according to the model contract and benefit RFQ’s.
• Develop and update the department’s letters and create and maintain a central repository for the letter library. Coordinate with Amida Care’s compliance department to get necessary correspondence submitted and approved by BPIE. Track all documents from submission to approval.
MINIMUM JOB REQUIREMENTS
• Bachelor’s degree in business, health care, project management or a similar field or an equivalent combination of education and related experience.
• Two years’ experience in a health related project management capacity and one year’s experience supervising professional staff in an office environment.
• Strong computer competency (MS Office applications) as well as experience with project management software is required as is an excellent attention to detail.
• Demonstrate understanding and sensitivity to multi-cultural values, beliefs, and attitudes of both internal and external contacts.
• Demonstrate appropriate behaviors in accordance with the organization’s vision, mission, and values.
Amida Care is a Diversity, Equity, and Inclusion employer committed to full inclusion and elimination of discrimination in all its forms. We strive to develop, promote, and sustain a culture that values equity and leverages diversity and inclusiveness in all that we do.
*All Amida Care employees must be fully vaccinated and must show proof of vaccination status.Position Description »