This place is answerable for supporting the Cost Containment Unit in drafting, documenting and gathering enterprise and technical necessities associated to initiatives which help the Unit’s efforts to offer company providers in Restoration and Cost Avoidance as associated to Claims funds for all strains of enterprise. The person will collect info from all associated stakeholders, keep challenge management updates, develop reporting instruments, draft course of flows and doc Normal Working Procedures. The place would require collaboration throughout company matrices. The place will entail representing the group as an issue professional on tasks and content material associated to the staff’s actions throughout all strains of enterprise. Will act as a liaison between Virginia Premier (VPHP) and the exterior Cost Containment distributors employed, assuring compliance with all laws whereas maximizing efficiencies and return on funding. Take part in creating new alternatives and have interaction in new vendor choice as required.
POSITION DUTIES AND RESPONSIBILITIES
Develop, compile and distribute studies associated to Cost Containment initiatives.
Draft newly created course of flows and keep current course of flows and associated documentation.
Draft Normal Working Procedures, Course of Maps and keep updates to modifications made on present paperwork underneath steerage of Supervisor.
Develop knowledge pushed instruments to research vendor effectiveness and return on funding for every contractual association and for the unit as an entire.
Analysis, collect and doc necessities for adhoc reporting, venture initiatives and new vendor or enterprise improvement alternatives in compliance with all contractual obligations, together with DMAS and/or CMS.
Carry out knowledge evaluation for tasks, together with value profit, return on funding, development evaluation, bench marking and hole evaluation, and outcomes metrics measurement.
Doc all undertaking standing updates together with contact info, overview, obstacles, subsequent steps and accomplishments.
Keep oversight of Undertaking Plans making certain all updates are made in well timed style. Comply with up on assigned duties that are close to or have exceeded due dates.
Doc and keep all activity schedules and associated deliverables by way of SharePoint repository.
Guarantee all stories have been compiled and delivered to applicable events as scheduled.
Carry out root trigger evaluation and coordinate corrective actions via Director and accountable events.
Create, keep and oversee Vendor Contract and course of movement encyclopedias making certain all documentation will meet necessities of Audits carried out.
Act as liaison between distributors and VPHP as required. Escalate problems with concern and monitor vendor effectiveness.
Achieve understanding of all VPHP techniques and instruments together with DBMS, SQL, Entry, Excel, IDX, QNXT, Visible Studio, Knowledge Warehouse extract instruments, automation instruments in addition to FTP protocols together with each setup and upkeep.
Doc all technical specs for brand spanking new implementations of vendor software program together with testing help in state of affairs improvement and system testing.
Present help within the improvement, implementation and oversight of Program Integrity capabilities to determine Fraud and Abuse controls. Keep and enhance as directed.
Companion with Supervisor and different Management to determine and develop additional restoration and avoidance alternatives, refine and keep after supply.
Profile vendor outcomes, claims cost discrepancies and system or course of inefficiencies; carry out knowledge analytics to find out root trigger and examine system configuration or course of modifications required for corrective motion.
Draft Change Gear submissions for approval by senior degree analysts or Supervisor in requesting configuration or course of modifications. MINIMUM EDUCATION REQUIREMENTS
Bachelor’s Diploma in Business, Finance, Health Administration, Arithmetic, Info Methods or associated fields of research.
SPECIAL KNOWLEDGE AND/OR SKILLS
Proficiency in Microsoft Workplace Merchandise with emphasis on Excel (should be capable of create formulation and analyze knowledge and powerful use pivot tables)
Demonstrated means in compilation, evaluation, and presentation of knowledge.
Potential to work independently and handle a number of duties and priorities.
Potential to successfully talk each verbally and in written type with numerous ranges of staff all through the group.
Work successfully in a quick previous paced, collaborative group surroundings throughout the company spectrum with consideration to element orientation.
Information of DBMS, TSQL, Entry or one other structured question language or associated Business Intelligence software.
Home windows Working Methods: Home windows 7 Skilled
Expertise in supporting finish customers in a company surroundings.
Undertaking Administration Expertise and expertise in use of Challenge Administration associated instruments.
Robust documentation and time management expertise.
WORK BACKGROUND/EXPERIENCE
Required Minimal 2-5 years of expertise knowledge evaluation, venture management, course of enchancment and/or report improvement position.
1-2 years expertise in a enterprise/reporting/techniques evaluation position. (Healthcare most popular)
Undertaking Administration expertise mixed with PowerPoint presentation improvement.
Expertise in improvement of reporting for Government/Senior Management.
Demonstrated expertise in SharePoint.
Vendor relationship coordination expertise.
PHYSICAL REQUIREMENTS
Bodily well being enough to satisfy the ergonomic requirements and calls for of the place.
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