Manager, Encounter Submissions at HMSA

Honolulu, Hawaii, United States -

Full Time

Start Date

Immediate

Expiry Date

10 Sep, 26

Salary

0.0

Posted On

12 Jun, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Encounter Submissions Management, Program Management, Team Leadership, Data Reconciliation, Risk Adjustment, Financial Analysis, Performance Management, System Implementation, Microsoft Office, Information Systems, Strategic Decision Making, Process Optimization

Industry

Insurance

Description

1. Encounter Submissions Management * Communicates with LOB leads and Governance Finance Director on the necessary information and context for strategic business decision making. * Establishes schedule for meetings and deliverables to complete needs of all 3 lines of business encounter submissions. * Supports audits of encounter data and minimizes risks of findings from submission activities. * Ensures encounter submission data is meeting requirements for risk adjustments as set by relevant government entities. * Manages implementation of new solutions as needed. * Oversees data reconciliation and research. Resolves issues with encounter data reported through vendor partners recommending or implementing corrective actions. * Analyzes project objectives, data sources, methodology, and data summaries and findings. * Responsible for production, delivery, and efficacy review of reports for internal and external audiences. * Coordinates and prioritizes activities with internal and external staff for implementation and monitors work for accuracy. 2. Program and Team Management * Coordinates work of the encounters submission workgroup, ES team, and ES vendor(s). * Provides guidance and development to team members. * Responsible for performance management and staffing. * Builds business case for additional resourcing needs. * Delegates some leadership to senior analysts and oversees outcomes and communication. 3. Continuous Improvement * Develops strategies to improve encounter submission passthrough and communication of opportunities to business owners. * Creates culture of continuous improvement and a working environment to support encounter submissions, financial analysis, and reporting for Government Finance. 4. Subject Matter Expertise * Monitors and evaluates changes in the external/internal environment, making changes to staffing and workflows to adapt. * Forecasts gaps in SME and requests investments in internal or external resourcing. * Develops and implement changes to processes and procedures that optimize revenue. 5. Documentation * Ensures complete documentation of program policies and procedures. 6. Performs all other miscellaneous responsibilities and duties as assigned or directed. #LI-Hybrid Qualifications 1. Bachelor's degree and four years of related experience; or an equivalent combination of education and related work experience. 2. One year of supervisory or management experience. 3. Effective verbal and written communication skills. 4. Proven success with system implementation and analytical work. 5. Intermediate working knowledge of Microsoft Office applications, including but not limited to Outlook, Word, and Excel. 6. Strong knowledge of Information Systems.

Responsibilities

Manage encounter submissions across three lines of business, ensuring data accuracy for risk adjustments and government requirements. Lead the encounter submission team and vendors while driving continuous improvement in financial reporting and revenue optimization.