JOB SUMMARY
HNAS (Health Now Administrative Services) offers flexible, cost-effective solutions for employee health benefits. HNAS is part of Highmark Health, a national blended health organization with a mission to create remarkable health experiences. Our culture is built on your growth and development, collaborating across our organization, and making a big impact for those we serve.
This job supervises and coordinates the day to day activities of the various claims processing or claims adjustment units responding to internal inquiries or inquiries received by members, providers, or account representatives across all markets.
This job administers the day-to-day activities related to collecting, analyzing and reporting on source data and key performance metrics for the purpose of supporting operational efficiency, overall tracking of business performance and management intelligence for effective decision-making. Along with managing and coaching employees, the incumbent will also support consultation with cross-functional groups and levels to identify data and analytical needs, conduct analyses, review analyses and findings with leadership, facilitate related process/data improvement efforts, and develop executive level presentations.
ESSENTIAL RESPONSIBILITIES
Perform management responsibilities to include, but are not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity. Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority.
Provide service support, training and performance statistics to the team in addition to initiating and implementing process improvements.
Ensure consistency and accuracy of information and reporting by identifying issues and fluctuations with core metrics/key performance indicators (KPIs), facilitate changes; research questions; participate and/or lead process and data improvement efforts.
Contribute to ensuring that all changes to reporting, processes, and procedures are reflected, appropriately documented and that consistency is maintained for team. Ensure the correct first time /quality review processes are utilized and that changes maintain data integrity control processes.
Set appropriate targets, measure outcomes and establish plan to negate variances in quality, staff retention, finance and customer satisfaction.
Assure that all staff achieves the minimal qualification of their position through ongoing staff development, counsel and motivate employees, evaluate employees, investigate complaints or performance concerns; implement disciplinary action as needed and in consultation with appropriate authority and Employee Relations.
Communicate changes in processes and programs in order to enhance a shared vision and mission.
Participation in the development and implementation of department/division project. This will include enhancements to report processes, harvesting data and streamlining.
Other duties as assigned or requested.
EDUCATION
Required
Bachelor's Degree in Math, Computer Science, Quantitative Business Analysis, Finance or related discipline
Substitutions
6 years related and progressive experience in Reporting and Analysis in lieu of bachelor degree
Preferred
Master's Degree in Math, Computer Science, Quantitative Business Analysis, Finance or related discipline
EXPERIENCE
Required
5 years in Reporting or Analytics
To Include
1 years of People Management/Team Lead
Preferred
None
LICENSES or CERTIFICATIONS
Required
None
Preferred
None
SKILLS
Experience in workforce development and resource management with excellent team building and professional development skills
Must demonstrate excellent leadership skills and be able to relate to all levels of management and staff as well as individuals external to the corporation
Ability to multi task and perform in a fast paced, and often intense environment
Excellent written and verbal communication skills
Ability to analyze data, measure outcomes and develop action plans
Team player that possesses strong analytical and organizational skill
The ability to prioritize work demands and meet deadlines
Strong leadership, collaboration and motivational skills
Languages (Other than English)
None
Travel Required
0% - 25%
PHYSICAL, MENTAL AND WORKING CONDITIONS
Position Type
Remote
Teaches / trains others regularly
Occasionally
Travel regularly from the office to various work sites or from site-to-site
Occasionally
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
Yes
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Rarely
Lifting: 25 to 50 pounds
Never
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements
Pay Range Minimum:
$67,500.00Pay Range Maximum:
$126,000.00Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
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What We Do
Highmark Health, a Pittsburgh, PA based enterprise that employs more than 40,000 people who serve millions of Americans across the country, is the second largest integrated health care delivery and financing network in the nation based on revenue. Highmark Health is the parent company of Highmark Inc., Allegheny Health Network, and HM Health Solutions. Highmark Inc. and its subsidiaries and affiliates provide health insurance to nearly 5 million members in Pennsylvania, West Virginia and Delaware as well as dental insurance, vision care and related health products through a national network of diversified businesses that include United Concordia Companies, HM Insurance Group, and Visionworks. Allegheny Health Network is the parent company of an integrated delivery network that includes eight hospitals, more than 2,800 affiliated physicians, ambulatory surgery centers, an employed physician organization, home and community-based health services, a research institute, a group purchasing organization, and health and wellness pavilions in western Pennsylvania. HM Health Solutions focuses on meeting the information technology platform and other business needs of the Highmark Health enterprise as well as unaffiliated health insurance plans by providing proven business processes, expert knowledge and integrated cloud-based platforms. A national blended health organization, Highmark Health and our leading businesses support millions of customers with products, services and solutions closely aligned to our mission of creating remarkable health experiences, freeing people to be their best. Headquartered in Pittsburgh, we're regionally focused in Pennsylvania, Delaware, West Virginia and New York, with customers in all 50 states and the District of Columbia. We passionately serve individual consumers and fellow businesses alike. Our companies cover a diversified spectrum of essential health-related needs, including health insurance, health care delivery, population health management, dental solutions, reinsurance solutions, and innovative technology solutions. We’re also proud to carry forth an important legacy of compassionate care and philanthropy that began more than 170 years ago. This tradition of giving back, reinvesting and ensuring that our communities remain strong and healthy is deeply embedded in our culture, informing our decisions every day.
