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Manager of Provider Reimbursement

Oakland, CA · Healthcare
Manager of Provider Reimbursement –  Managed Care
San Leandro, CA (South Oakland Area)
 
Manager of Provider Reimbursement Job Summary:
  • Lead the claims team and payment program through developing subject matter expertise in the MediCal benefit program to ensure that staff are able to appropriately and efficiently process claims to meet internal and regulatory standards
  • Utilize innate logic and creativity to develop an outstanding program in provider reimbursement. 
  • Supervise, inspire, and professionally develop staff
  • Using subject matter expertise of the MediCal benefit package, ensure compliance with regulatory and health plan requirements related to provider reimbursement
  • Engage with staff to re-imagine and implement improved workflows using innovation and technology
  • Develop and maintain an evolving training curriculum for staff
  • Utilize data and concrete metrics to monitor, evaluate, and improve reimbursement performance
  • Collaborate with staff across departments to ensure alignment and effective implementation of policy and procedures
  • Serve as subject matter expert in provider reimbursement and research and resolve complex inquiries
 
Manager of Provider Reimbursement Background:
  • Bachelor's Degree is required, Master's Degree is preferred
  • At least 1 year experience supervising staff or leading teams in  provider claims or provider reimbursement
  • Ability to interpret MediCal benefit rules and apply to provider reimbursement
  • Ability to communicate effectively, both verbally and in writing
  • Comfortable with electronic tools such as Excel or SQL to support data analysis
  • Strong interpersonal and problem solving skills with attention to detail
  • Ability to inspire teams of people and collaboration across departments
  • Ability to work independently and prioritize multiple projects
#ADMIN
 
 
RON AMODIO
STRATEGIC DIRECTOR
CareNational
ron@carenational.com
480.269.9491 (CALL – TEXT – FAX)
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