Claims Operations Manager- Contract

Affinity Health Plan, an independent, growing, not-for-profit managed care company designed specifically to serve the needs of low-income New Yorkers, needs a CONTRACTOR for a three to five month assignment to work as a Claims Operations Manager. Reporting to the Director of Claims, you will be responsible for the planning oversight, and ongoing work of all claims functions. This includes responsibility for the efficient, accurate, and timely processing of all claims and encounters. Your responsibilities will include but are not limited to the management of processing and support staff ensuring compliance with Affinity Health Plan and CMS (Center for Medicare and Medicaid Services) standards, and along with the others in the claims management team you will identify and participate in the design and implementation of modifications to the claims processing system to improve the efficiency and accuracy of claims processing. You will also be expected to manage staff development as well as the development of programs and initiatives to enhance staff performance, teamwork and overall satisfaction.

 

Requirements for this three to five month CONTRACT position include an undergraduate degree, preferably in healthcare or business / management or the comparable work experience equivalent; five (5) years or more of progressively responsible health care and claims operations management experience, and strong Microsoft Office skills. Working knowledge of Amisys or Facets is strongly preferred over other processing systems. You must have thorough knowledge of managed health care including excellent, demonstrated knowledge of claims processing, excellent verbal and written communication skills, and demonstrated proficiency with staff management and development. This job requires a high level of analytical ability, initiative and judgment combined with the ability to manage in a complex and fast paced environment. You must be able to work autonomously as well as in a team from an operational, management and system perspective. Excellent interpersonal skills are required as well as a high level of diplomacy to interact with internal departments, external professionals and providers by phone, in person and in writing. If you meet these qualifications and are interested in this position, please respond through our website, http://www.affinityplan.org under Careers/Open Positions on the main page. You can also fax your resume to 718-794-7846, stating that you are applying for this position on the fax cover sheet. We are an Equal Opportunity/AA Employer. Only qualified applicants will receive a response. Direct responses only please; no agencies.