14 days old

Manager, HCS Commercial MSP Operations

Nashville, TN 37203
Regular Full Time

The Healthcare Commercial MSP Operations Manager oversees and drives business operations for Performants commercial Medicare Secondary Payer (MSP)-related solutions (*does not include CMS CRC MSP).

Essential Duties
Responsible for operational P&L for Commercial MSP line of business.
Lead implementation of new accounts
Develop business plans for full scalability, including funding, staffing, and technology modeling
Plans and collaborates to ensure appropriate staffing levels and staff competencies for assigned business 
Proven experience in developing and managing high performing dynamic teams
Manages  commercialMSP operations and contributes to development/enhancement of operational infrastructure.
Ensure team(s) consistently achieve operational metrics and goals, quality, and compliance requirements.
Builds business value and credibility internally and externally and represents the organization in meetings with the clients and other commercial MSP business constituents.
Uses excellent communication skills to influence a wide range of internal and external audiences.
Leads by example and adheres to all Company policies and procedures in performance of job duties and all interactions.
Develop and implement operational training for staff to support operational quality and compliance, and optimal service delivery to clients.
Actively identify opportunities and develop solutions for increased efficiencies to processes, systems and tools used in delivering client services.
Performs other duties as assigned.


Required Skills and Knowledge:
Extensive depth and breadth of experience with Medicare, Other Health Insurance (OHI), Coordination of Benefits (COB) and Third-Party Liability (TPL) business models and products.
Experience successfully leading OHI and TPL specific businesses and driving operational results, with some P&L responsibilities.
Working knowledge of requirements gathering, ETL processing, data matching, and databasing.
Demonstrated ability to meet top and bottom line revenue targets for a rapidly expanding business.
Excellent professional written and verbal communication skills.
Understands and adheres to HIPAA standards and regulations.
Perform other duties as may be required to meet business needs.
Strong critical thinking, analytical and problem-solving skills.
Self-motivated and thrives in a fast-paced business performing multiple tasks cohesively, with keen attention to detail.
Ability to adapt quickly and transition effectively to changing circumstances, client requirements, assignments, and business needs; and consistently performs job responsibilities.
Completion of Teleworker Agreement upon hire, and adherence to the Agreement (and related policies and procedures) including, but not limited to: able to navigate computer and phone systems as a user to work remote independently using on-line resources, must have high-speed internet connectivity, appropriate workspace able to be compliant with HIPAA, safety & ergonomics, confidentiality, and dedicated work focus without distractions during work hours.


Physical Requirements:

**NOTE: Must be able to meet requirements for and perform work assignments in accordance with Company policies and expectations on a home remote basis (and must meet Performant remote-worker requirements) until at which time staff will be notified and required to work from a Performant office location. Basic office equipment required to perform remote work is provided by the company.
Performs duties in a busy standard office environment with moderate noise level. (or home-based Telework environment in accordance with Company policies and procedures).
Sits or stands at a desk, reaching as needed to use office equipment.
Makes and returns calls using an office phone system or company issued cellular phone.
Views a computer monitor, types on a keyboard, and uses a mouse.
Reads and comprehends information in electronic (computer) or paper form (written/printed).
Types frequently, but not constantly, using a keyboard and mouse.
Occasionally lifts/carries/pushes/pulls up to 10 pounds.
Travel as required to meet business needs.


Education and Experience:

Bachelors degree in relevant field or equivalent combination of education and experience.
5+ years relevant professional level experience with increasing responsibility relevant to the position working with MSP, OHI, or COB data and processes.
3+ years in relevant leadership role(s). Previous experience demonstrating successful P&L ownership highly preferred.
Accomplished track record demonstrating the knowledge and skills required for the position.

Other Requirements

Must submit to and pass pre-hire background check, as well as additional checks throughout employment
Must be able to pass a criminal background check; must not have any felony convictions or specific misdemeanors, nor on state/federal debarment or exclusion lists.
Must submit to and pass drug screen pre-employment (and throughout employment).
Performant is a government contractor. Certain client assignments for this position requires submission to and successful outcome of additional background and/or clearances throughout employment with the Company.
Visa sponsorship is not available.

Job Profile is subject to change at any time.

Performant Financial Corporation is an Equal Opportunity Employer. 
Performant Financial Corporation is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law. 




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Posted: 2020-09-03 Expires: 2020-10-17
Analytics, audit, and recovery services for healthcare, government and student loans.

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Manager, HCS Commercial MSP Operations

Performant Financial
Nashville, TN 37203

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