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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** is responsible for overseeing the daily operations of the Data management team. The Data Management team is responsible for ensuring that claims processing platform is optimally and accurately configured to meet the organization’s strategic business operations. The Encounter team is responsible for designing, developing, and maintaining organizational programs that support contractual requirements of payer contracts, including but not limited to encounter programs. Additionally, this role will be responsible for leading and mentoring a team of technical professionals.

Duties include, but not limited to:

+ Ensure claims processing platform is optimally and accurately configured and maintained to meet the organization’s strategic business operational needs specific to vendor contracts, fee schedules, benefits/DOFR, and provider/vendor/place of service data. Responsible for developing and updating policies and procedures which support application system setup functions and work/audit processes within claims processing platform.

+ Provider data management: Oversees the configuration of provider-specific data, including fee schedules, reimbursement methodologies, network assignments, and demographic information.

+ Benefits configuration: Translates complex benefit plan documents (like Summary Plan Descriptions) into system rules, logic, and cost-sharing structures such as co-pays, deductibles, and out-of-pocket maximums

+ Contract and pricing implementation: Accurately configures and tests new and updated provider contracts and pricing models to ensure correct claims payments according to negotiated terms.

+ Coding and logic setup: Ensures the system correctly processes claims based on standard coding systems, including CPT, ICD-10, and HCPCS

+ Represents the Data Management team to executive management and follows up with internal customers to ensure all business objective expectations are met. Works to established service levels per business requirements and acts as the primary point of escalation for the Data Management team.

+ Manage yearly CMS rate change implementation and validation.

+ Identifies opportunities to enhance operational efficiency, accuracy, and auto-adjudication rates within the claims system through workflow and process improvements.

+ Establishes quality control metrics and tracking mechanisms for configurations. Manages testing and validation of all system changes before implementation.

+ Works closely with other departments, including Claims Operations, IT, Provider Contracting, and Compliance, to align on system setup and resolve issues.

+ Supports system migrations, client implementations, and other special projects that impact claims configuration.

+ Acts as an escalation point for complex configuration and claims processing issues, performing root cause analysis and implementing corrective actions.

+ Stays current with federal and state healthcare regulations (e.g., ACA, HIPAA) and ensures all system configurations comply with legal standards

+ Coordinates responses to internal and external audits, implementing new processes to address any findings and ensure compliance.

+ Monitors configuration performance and generates regular reports for management on quality metrics, system error rates, and team productivity.

+ Create and lead a scalable program that includes encounter data management, submissions, reject remediation, and client/internal reporting as well as coordination and reconciliation with state regulatory bodies.

+ Leads analyses independently and coordinates with the Finance Division to review financial performance based on encounter submissions. Perform other duties as assigned.

Knowledge, Skills and Abilities: This position requires the following minimum requirements:

+ Extremely strong verbal and written communication skills targeted at both high-level external stakeholders as well as internal peers and executives.

+ Strong management and interpersonal skills to facilitate team towards achievement of stated functional goals as well as to help develop internal skill sets and performance.

+ Advanced knowledge of healthcare, managed care, contract related activities including negotiations, legal, regulatory, operational, financial and relationship management.

Education:

+ Bachelor’s Degree or equivalent combination of education and 5+ years of work experience.

Experience:

+ 5+ years of experience in managed healthcare, analysis, and problem solving required.

+ 5+ years of experience managing a team supporting managed healthcare systems/processes required.

+ 7+ years professional managed healthcare administration experience in IPA with 5+ years management experience preferred

ADDITIONAL INFORMATION

This job description outlines the general responsibilities and requirements of the Manager, Data Management role. Duties and expectations may evolve based on organizational needs.

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.