Manager, Encounter Submissions

Job Summary

Hybrid Work Environment - Must reside on Oahu
Pay Range: $78,000 - $153,000, position is eligible for an incentive bonus
Responsible for managing the team and performance outcomes of the encounter data processing from HMSA to customers as well as communicating the performance both internally and externally.
Requires driving collaboration and co-solutioning with other departments to maximize pass-through of encounter information.

Duties And Responsibilities

• 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.
• Sustains subject matter expertise in the regulatory changes as well as internal documentation of policies and procedures.
• Assists with audits, ongoing submissions, and other government finance deliverables.

Encounter Submissions Management

• 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.
• Solves issues with encounter data reported through vendor partners recommending or implementing corrective actions.
• Analyzes project objectives, data sources, methodology, and data summaries and findings.
• Produces, delivers, and efficacy reviews of reports for internal and external audiences.
• Collaborates with internal and external staff for implementation and monitors work for accuracy.
• Coordinates and prioritizes activities with internal and external staff for implementation and monitors work for accuracy.

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.
• Buils business case for additional resourcing needs.
• Delegates some leadership to senior analysts and oversees outcomes and communication.
• Continuously improves encounter submission passthrough and communication of opportunities to business owners.
• Creates a culture of continuous improvement and a working environment to support encounter submissions, financial analysis, and reporting for Government Finance.

Subject Matter Expertise

• Maintains monitoring and evaluation of 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 implements changes to processes and procedures that optimize revenue.
• Ensures complete documentation of program policies and procedures.