Health Information Systems Manager (Managed Care Enrollment)


Job Type

Full Time

Published:

03/29/2018

Address

330 West 42nd Street
New York
New York
10036
United States

Description

The 1199SEIU Benefit & Pension Funds provide comprehensive health, pension, and quality of life benefits to unionized workers represented by 1199SEIU United Healthcare Workers East. We are among the largest labor-management funds in the nation, covering 400,000 members and their families.


If you’re ready for the brightest career future, join us in this excellent opportunity to showcase your talents. We are currently seeking an experienced Health Information Systems Manager (Managed Care Enrollment) for our Eligibility department. 


Responsibilities


  • Oversee daily retiree and pension related inquiries; provide guidance for reviewing and interpreting results of the eligibility nightly batch and control reports; audit control reports daily
  • Prepare monthly HIP/HUMANA auto enrollment EDI files and process response file in the Eligibility system (Vitech V3); prepare weekly EGWP file
  • Conduct monthly reconciliation for HIP, HUMANA and EGWP; update V3 based upon transactions and communications with HIP, HUMANA, CMS, Medco, Retirees Division, Member Services and retired members
  • Oversee GNY spousal open enrollment election process and perform monthly reconciliation of covered spouses
  • Extract and analyze eligibility data from V3 using PL/SQL; generate internal control reports and ad-hoc reports for other departments
  • Meet with upper management to review and discuss reporting methodology, workflow and internal controls
  • Conduct Medicare Part D Final year end reconciliation of covered retirees
  • Supervise staff in accordance with Human Resources Operating Policies and Procedures, the established department service goals and requirements, and the provisions of the Collective Bargaining Agreement
  • Conduct training for staff to ensure they apply policies and procedures, and are kept informed of updated information
  • Perform additional duties as assigned by management


Qualifications


  • Bachelor’s degree in Health Information Technology, Healthcare Administration, Public Health Administration, Computer Science or equivalent years of experience required
  • Minimum of five (5) years database management, business analysis or systems analysis experience; to include two (2) years supervisory experience in a health environment required
  • Experience working with CMS, HIP and HUMANA
  • Experience in a Taft Hartley Pension and Health Insurance Plan highly preferred
  • Thorough understanding of active members and retiree eligibility rules
  • Understanding of Vitech V3 benefits administration system or similar systems highly preferred
  • Advance skill level in Microsoft Office and PL/SQL required; ability to write queries, code and generate reports
  • Excellent communication, planning, presentation and organizational skills
  • Strong analytical skills and problem solving abilities; able to interpret customer business needs and translate into operational requirements
  • Strong leadership skills with ability to foster strong relationships and handle confidential situations with tact and discretion
  • Able to prioritize assignments and meet deadlines
  • Must meet performance standards including attendance and punctuality


Benefits

medical, dental, no copay, prescription, tuition reimbursement, 401K

Professional Level

Managerial

Minimum Education Required

4-year degree

How To Apply

http://chm.tbe.taleo.net/chm03/ats/careers/requisition.jsp?org=NBF1199&cws=1&rid=7209

We offer a competitive salary, an excellent fully employer-paid comprehensive benefits package and talented professional colleagues. For consideration and to apply, please visit us at http://chm.tbe.taleo.net/chm03/ats/careers/requisition.jsp?org=NBF1199&cws=1&rid=7209. Please mention you saw this ad in Idealist. We are an Equal Opportunity Employer.


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