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.
Responsibilities:
As part of the Community Health Choices Service Coordination Team, the Operations Reporting Analyst Supervisor is responsible for the oversight and management of the Operations Reporting Analyst team and responsibilities. The Operations Reporting Analyst team is responsible for the completion of the Service Coordination components of OLTL Ops reporting process through the improvement and completion of existing state mandated reporting requirements while maintaining a high level of accuracy, integrity and timeliness of data reports.
Principal Accountabilities:
- Executes on organizational efforts in ongoing quality improvement processes to ensure compliance with State, Federal, regulatory and accrediting body’s standard requirements and statutory reporting policies and procedures.
- Develop and maintains a complete understanding of all data sources available for reporting of CHC Service Coordination data.
- Develops and maintains strong knowledge of business practices and the managed care industry in general and applies knowledge to determining data and report solutions.
- Leads team in completing all regulatory reporting requirements assigned, accurately and meeting all deadlines. Failure to do so may result in the company incurring financial penalties, decreased satisfaction by client, and compromised relationship with state or other regulatory agencies.
- Will conduct auditing of all Operation Reports including data validation, documentation, quality and timeliness using trending, benchmarking or other analyses to ensure data integrity.
- Maintains electronic and paper documentation supporting the completion of each report for each reporting period within departmental guidelines.
- Identifies resolves and/or escalates problematic Ops Reporting areas that may place plan at risk of not achieving annual goals.
- Leads team in ensuring reporting is accurate and timely, as well as, identifies and researches problem areas that potentially compromise accuracy or integrity of the data reported.
- Serves as a resource to other departments in completing Ops Reporting requirements and goals.
- Works professionally and efficiently with all functional areas in meeting organizational and departmental goals.
- Responsible for providing input into the development of Ops Reporting projects and accountable for the execution and documentation of those projects ensuring identification of root cause; with the assistance of the Manager, Director of Service Coordination and Regulatory Reporting leadership establishes a work plan to implement interventions.
- Leads team in the implementation of interventions aimed at improving quality performance.
- Responsible for creation and submission of state reporting documentation of activities and projects within his/her scope of responsibility and in collaboration with leadership and Regulatory Reporting.
- Uses data and analysis tools to identify opportunities for improved performance and collaborates with team, Service Coordination leadership and Regulatory Reporting to develop intervention strategies.
- Removes barriers to achieve successful completion of strategic projects.
- Conducts analysis and provides summary reports and analysis to senior management.
- Other duties as assigned.
General:
- Works in a collaborative manner with all providers, members, departments within the AmeriHealth Caritas Family of Companies to conduct ongoing process and data review to identify opportunities for improvement.
- Performs ad-hoc analysis of any underperforming or “broken” processes by collaborating with Subject Matter Experts and/or Customers to define existing processes and make recommendations for improvement.
- Responsible for the management and development of new and existing staff.
Education/ Experience:
- Bachelor’s Degree preferred.
- 1 to 3 years leadership experience.
- Minimum of 3 years in service quality improvement or service coordination required.
- Minimum of 3 years in human service delivery required.
Other Skills:
- Managed Healthcare experience preferred.
- Excellent organizational, analytical and interpersonal skills.
- Excellent written and verbal communication skills.
- Ability to work successfully within all levels of the organization.
- Proficient PC skills in a windows based environment, including Excel.
Work Arrangement:
- Remote, some travel required
- Qualified candidates must live in EST time zone
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.