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  • Manager of Data Management

    HCA Healthcare (Nashville, TN)



    Apply Now

    Description

    Introduction

     

    Are you passionate about the patient experience? At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like family! Jump-start your career as a Manager of Data Management today with HCA Healthcare.

     

    Benefits

     

    HCA Healthcare offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

     

    + Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.

    + Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.

    + Free counseling services and resources for emotional, physical and financial wellbeing

    + 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)

    + Employee Stock Purchase Plan with 10% off HCA Healthcare stock

    + Family support through fertility and family building benefits with Progyny and adoption assistance.

    + Referral services for child, elder and pet care, home and auto repair, event planning and more

    + Consumer discounts through Abenity and Consumer Discounts

    + Retirement readiness, rollover assistance services and preferred banking partnerships

    + Education assistance (tuition, student loan, certification support, dependent scholarships)

    + Colleague recognition program

    + Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)

    + Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

     

    Learn more about Employee Benefits (https://careers.hcahealthcare.com/pages/employee-benefits-and-rewards)

     

    _Note: Eligibility for benefits may vary by location._

     

    Come join our team as a Manager of Data Management. We care for our community! Just last year, HCA Healthcare and our colleagues donated $13.8 million dollars to charitable organizations. Apply Today!

     

    Job Summary and Qualifications

     

    The Manager of Data Management’s primary function is to analyze new plan documents and perform benefit coding to load benefits using a table based computer claims system. This position will also be responsible for loading and maintaining other system control files to support claims processing, membership, provider and authorization processing, and to oversee and manage the Electronic Claims System, ACO/PPO Eligibility, & Excelicare staff, and Provider Database staff.

    DUTIES INCLUDE BUT NOT LIMITED TO:

    Oversee the coordination with Health Plans for the receipt for new plan documents

     

    Implement new plan documents using table based computer system

     

    Analyze benefit categories and adjudication rules to create new benefit types

     

    Maintain benefit category, plan coding and data values in system for all lines of business and all business entities

     

    Manage the process of running jobs on computer system to upload data, research, correct and post data to computer system

     

    Interfaces with multiple departments and technical staff for system implementation issues and changes

     

    Manage the implementation of provider data in multiple systems

     

    Analyze provider contracts and input provider pricing into table based computer system

     

    Manage yearly CMS rate change implementation and validation

     

    Direct the process of inputting of pricing schedules into system

     

    Research and resolve member file, provider file, plan coding and pricing issues

     

    Performs systems testing when updates and/or new releases are made to the computer system

     

    Conducts training session for users

     

    Keep IT informed of system and operational issues

     

    Manage the Electronic Claims processing staff

     

    Maintain the Electronic Funds Transfer system implementation

     

    Manage the AS400 implementation of new claims business (plans, providers, DOFR, fee schedules)

     

    Maintain the Finance Recovery Table for internal Healthplan billback process

     

    Maintain the Provider Override Table in Access Express for Utilization Management for authorization purposes

     

    Manage the Excelicare and Encounter staff

     

    Manage AS400 system changes and updates

     

    Perform other duties as assigned

    KNOWLEDGE, SKILLS AND ABILITIES:

    This position requires the following minimum requirements:

    Demonstrated analytical skills with ability to review information to determine appropriate action and define and resolve problems

     

    Deep understanding of health plan benefits coding

     

    Excellent written and verbal communication skills

     

    Computer skills capable of running batch processes on mainframe system and managing data files and running batch process on PC environment

     

    In depth knowledge of health care industry

     

    Demonstrated ability with PC software

     

    Ability to maintain documentation in format, which is easily understood by users Knowledge in MS Access and MS Excel

     

    Firm understanding of claims systems and claims process

    EDUCATION:

    Bachelor’s Degree or equivalent work experience required

    EXPERIENCE:

    Four years of experience required

     

    Experience loading/updating benefit plans and health plan contracts

     

    Claims experience and/or strong knowledge of claims processes

     

    Physician Services Group (https://careers.hcahealthcare.com/pages/physician-services) is skilled in physician employment, practice and urgent care operations. We are experts in hospitalist integration, and graduate medical education. We lead more than 1,300 physician practices and 170+ urgent care centers. We are HCA Healthcare’s graduate medical education leader. We provide direction for over 260 exceptional resident and fellowship programs. We focus on carrying out value-added solutions. These solutions help physicians deliver patient-centered healthcare. We support HCA Healthcare's commitment to the care and improvement of human life.

     

    HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

     

    "The great hospitals will always put the patient and the patient's family first, and the really great institutions will provide care with warmth, compassion, and dignity for the individual."- Dr. Thomas Frist, Sr.

     

    HCA Healthcare Co-Founder

     

    If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Manager of Data Management opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. **Unlock the possibilities and apply today!**

     

    We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

     


    Apply Now



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