Back to Jobs search

Healthcare Claims Sr Manager

General Dynamics Information Technology • Raleigh, NC • 16h ago

Req ID: RQ202570

Type of Requisition: Regular

Clearance Level Must Be Able to Obtain: None

Public Trust/Other Required: None

Job Family: Healthcare Claims

Skills:

Call Center,Deliverables Management,Leadership,People Management,Training

Experience:

5 + years of related experience

Job Description:

Healthcare Claims Sr Manager

Drive better health outcomes for our clients as a Healthcare Claims Sr Manager at GDIT. Here, your work will impact many as you deliver healthcare expertise and services where they are needed most. Own this opportunity to advance not just, patient outcomes, but also your personal career growth.

At GDIT, people are our differentiator. As a Healthcare Claims Sr Manager, you will help ensure today is safe and tomorrow is smarter. Our work depends on Healthcare Claims Sr Manager joining our team to manage staff and key deliverables to meet service agreements and consistently deliver high quality and timely service.

HOW A SENIOR MANAGER HEALTHCARE CLAIMS WILL MAKE AN IMPACT

You will act as a thought partner to the leadership team to provide support and counsel for operations management, communications, initiatives and projects.

You should be a self-starter with outstanding organization and communication skills, fast paced environment.

Understand strategic financials regarding areas of oversight.

Proven ability to build strong partnerships with colleagues, desire to be flexible and think proactively, strategically, and analytically about diverse business solutions and leading professional working groups.

Ability to make critical decisions with limited guidance while ensuring visibility into those decisions.

A demonstrated understanding of Medicaid support operations and an appreciation for how to prioritize among demands and balance the levers that make a complex business run smoothly and productively.

Manages Provider Enrollment operations for NCMMIS program, including optimizing resources to facilitate SLA deliverables and maximize efficient operations.

Manages change management efforts and reporting to optimize SLAs and ensure optimization of resources.

Serve as lead cross departmental deliverables for operations, including internal and external audits, business continuity, and other program operations deliverables.

Serve as a resource for operational managers and assist with training and mentoring operational managers regarding key operational processes.

Lead cross departmental operational efforts for internal and external quality assessments, audits and surveys.

Lead cross departmental communication initiatives to both internal and external stakeholders, including community engagement efforts and efforts to facilitate employee engagement.

Manage and oversee key departments, including training and operational data efforts to optimize efficiencies and ensure effective operations.

Oversee and coordinate NCQA CVO efforts and all supporting efforts.

Manages and optimizes customer and key stakeholder relationships, including escalations and developing processes to facilitate timely management of provider enrollment related escalations.

WHAT YOU'LL NEED TO SUCCEED:

Education: Bachelor's Degree in related technical, scientific, business, health or a related discipline

Required Experience: 5+ years of related experience

Required Skills and Abilities: Medicaid Operations Leadership Support , Project Management Skills, Provider Enrollment Management Skills and Experience, NCQA CVO knowledge and experience.

Demonstrated ability to communicate issues, impacts, and corrective actions

Demonstrated ability to easily and effectively communicate project topics to a diverse audience

Demonstrated ability to clearly report relevant information

Preferred Skills: SharePoint, Excel, PMO, PowerPoint

Location: Hybrid

US Citizenship Required

GDIT IS YOUR PLACE:

401K with company match

Comprehensive health and wellness packages

Internal mobility team dedicated to helping you own your career

Professional growth opportunities including paid education and certifications

Cutting-edge technology you can learn from

Rest and recharge with paid vacation and holidays

The likely salary range for this position is $124,950 - $169,050. This is not, however, a guarantee of compensation or salary. Rather, salary will be set based on experience, geographic location and possibly contractual requirements and could fall outside of this range.

Our benefits package for all US-based employees includes a variety of medical plan options, some with Health Savings Accounts, dental plan options, a vision plan, and a 401(k) plan offering the ability to contribute both pre and post-tax dollars up to the IRS annual limits and receive a company match. To encourage work/life balance, GDIT offers employees full flex work weeks where possible and a variety of paid time off plans, including vacation, sick and personal time, holidays, paid parental, military, bereavement and jury duty leave. To ensure our employees are able to protect their income, other offerings such as short and long-term disability benefits, life, accidental death and dismemberment, personal accident, critical illness and business travel and accident insurance are provided or available. We regularly review our Total Rewards package to ensure our offerings are competitive and reflect what our employees have told us they value most.

We are GDIT. A global technology and professional services company that delivers consulting, technology and mission services to every major agency across the U.S. government, defense and intelligence community. Our 30,000 experts extract the power of technology to create immediate value and deliver solutions at the edge of innovation. We operate across 50 countries worldwide, offering leading capabilities in digital modernization, AI/ML, Cloud, Cyber and application development. Together with our clients, we strive to create a safer, smarter world by harnessing the power of deep expertise and advanced technology.

Join our Talent Community to stay up to date on our career opportunities and events at https://gdit.com/tc.

Equal Opportunity Employer / Individuals with Disabilities / Protected Veterans

Similar Jobs

New Graduate Nurse

Fresenius Medical Care North America • Apex, NC • 1h ago

Hospital & Medical

PURPOSE AND SCOPE: This position is for graduates of an accredited school of Nursing working in a state that does not allow graduates to perform nursing duties until licensed. The specific job title used will be determin...

1h ago

Go to Apply

New Graduate Nurse

Fresenius Medical Care North America • Raleigh, NC • 1h ago

Hospital & Medical

1h ago

Go to Apply

EReferral Specialist Home Health

CenterWell • Raleigh, NC • 11h ago

Hospital & Medical

Become a part of our caring community and help us put health first The E-Referral Specialist is an integral part of the referral process as this role is the initial contact point for the client or referral source to prom...

11h ago

Go to Apply

Pharmacy Account Manager, Carolinas Market - Cigna Healthcare - Remote

The Cigna Group • Raleigh, NC • 16h ago

Hospital & Medical

Pharmacy Account Executive (Non-IC) Advisor - Carolinas Market Work from Home: Preferably in North or South Carolina As part of Cigna Pharmacy Management, the Pharmacy Account Management Advisor serves as the primary pha...

16h ago

Go to Apply

Nurse Auditor

Humana • Raleigh, NC • 1d ago

Hospital & Medical

Become a part of our caring community and help us put health first The Nurse Auditor 2 will perform acute inpatient Short Stay Reviews/clinical audits considering complex medical factors and MCG, to ensure that medical r...

1d ago

Go to Apply

Compliance Nurse 2

CenterWell • Raleigh, NC • 1d ago

Hospital & Medical

Become a part of our caring community and help us put health first The Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to pr...

1d ago

Go to Apply

Licensed Clinical Therapist - Multistate

CVS Health • Raleigh, NC • 1d ago

Hospital & Medical

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions compan...

1d ago

Go to Apply

Clinical Research Nurse

Actalent • Raleigh, NC • 2d ago

Hospital & Medical

Job Description The Clinical Research Nurse will perform technical and clinical requirements of study protocols, including venipuncture, specimen processing, vital signs, electrocardiograms, etc. The role involves attend...

2d ago

Go to Apply

Clinical Research Nurse - R

Actalent • Raleigh, NC • 2d ago

Hospital & Medical

2d ago

Go to Apply

Medical Lab Tech

UNC Health Care • Holly Springs, NC • 2d ago

Hospital & Medical

Description Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve. This position is eligible for the Clinical Labora...

2d ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.