Business Engagement Manager - Remote

VetJobs; Pittsburgh (Allegheny County); Remote; USD 80,000 - 100,000; Full time

Job summary

A leading company is seeking a Business Engagement Manager to support Amerihealth Caritas health plans. This remote position requires expertise in operations and excellent communication skills to facilitate relationships and ensure optimal performance across departments.

Benefits

Flexible work solutions

Health insurance coverage from Day 1

401(k) plan

Tuition reimbursement

Paid time off including holidays

Qualifications

• Minimum of 3 years experience in healthcare or managed care.
• Proven ability to execute effective business strategies.
• Excellent verbal communication and presentation skills.

Responsibilities

• Manage engagement activities for Amerihealth Caritas health plans.
• Facilitate on-site visits and presentations.
• Coordinate issue resolutions across functional teams.

Skills

Problem solving

Communication

Relationship Management

Education

Bachelor’s Degree

Job description

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Job Description

On behalf of VetJobs/MilitarySpouseJobs, thank you for your interest. We are assisting our partnering company, listed below, with this position. It is open to Veterans, Transitioning Military, National Guard Members, Military Spouses, Wounded Warriors, and their Caregivers. If you have the required skill set, education requirements, and experience, please click the submit button and follow for next steps.

Job Description

On behalf of VetJobs/MilitarySpouseJobs, thank you for your interest. We are assisting our partnering company, listed below, with this position. It is open to Veterans, Transitioning Military, National Guard Members, Military Spouses, Wounded Warriors, and their Caregivers. If you have the required skill set, education requirements, and experience, please click the submit button and follow for next steps.

Responsibilities

Under the direction of the Director, Enterprise Operations Solutions, the Business Engagement Manager is responsible for handling the engagement activities to support all current Amerihealth Caritas health plans and corporate departments. This position must have and maintain knowledge of the federal and individual state’s requirements regarding operational functions, i.e. claim payments, contact center, and enrollment to ensure optimal operational performance for the assigned products and/or plans. They will intake, assess and monitor issues and inquiries related to EO raised by the health plans or other corporate departments. This position will collaborate with key functional areas across all lines of business to ensure completion of root cause analysis and rapid remediation deployment for internal/external requests as well as all exculpated issues from other departments/plans. The Business Engagement Manger is responsible for the following:

Maintains working knowledge of plan state contracts with a focus on Enterprise Operations (EO) related activities and the Service Level Agreements (SLA’s).

Responsible to facilitate plan affiliate on site visits as well as develop and conduct presentations as needed.

Establishes cross functional work teams to enable real time resolution of issues. Issues may include but are not limited to all EO functions (claims, call center, enrollment, etc.).

Serves as a single point of contact for affiliate plans and other corporate departments regarding any issues or requests related to Enterprise Service Operations.

Responsible for the primary interface between the plan and the corporate office to manage all relationships, issues, escalations, projects and inquiries.

Manages the day-to-day contacts and requests of health plans to ensure the health plans’ needs are met.

Track, monitor and drive resolutions to issues that impact achievement of key metrics per contractual requirements.

Takes on critical problem-solving tasks. Engages senior leadership as appropriate.

Builds trust and establishes customer relationships focused on open communication. Key customers include plans, IS leaders and corporate PMO.

Acts as a recognized change agent for the enterprise by influencing and establishing appropriate methods and opportunities to positively address the pace of change.

Responsible for tracking issue resolution against established timeline and alerts responsible department of upcoming due dates to ensure adherence to department standards. Escalates issues appropriately.

Develops and facilitates project plans, track work performed, work pending and open issues for team comprised of staff and clients.

Lead plan operational meetings, first alert meetings, key provider meetings, meetings with EO departments and ad hoc meetings as required.

Education/Experience

Bachelor’s Degree or Equivalent work experience required.

Proven ability to collaborate and execute actionable business strategies.

Problem solving and root cause identification skills.

Demonstrated ability to build effective relationships across all levels of leadership.

Excellent verbal communication, presentation and listening skills.

Track record of providing excellent customer service.

Minimum of 3 years of experience in healthcare, managed care, or insurance industry environment required.

Minimum of 5 years Operations experience with Account/Relationship Management responsibilities.

Previous Claims Experience And Knowledge Of Claims Operations Required.

Prior experience analyzing and defining solutions to complex business and technical issues.

Billing and coding experience/knowledge is a plus

Prior experience in managing multiple, large, cross-functional teams and projects, with an eye towards identifying and implementing opportunities to improve business processes.

Prior experience in environments with large, complex, real-time transaction volumes desired.

Maintaining a working knowledge of all EO Functions.

Ability to teach/train others.

Communication skills both oral and written.

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

Auto req ID

449470BR

Minimum Education Required

Bachelors

Job_Category

Operations

City*

Pittsburgh

State*

Pennsylvania

Job Code

OperationsManager Operations Manager

Affiliate Sponsor

AmeriHealth Caritas

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Information Technology

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