The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric, full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort to develop Dignity Health’s Medicaid population health management pathways. Dignity Health MSO is dedicated to providing quality administrative and clinical services to groups, hospitals, health plans, and employers with a business objective to excel in coordinating patient in a manner that supports containing costs while continually improving quality of and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient first.
Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art, flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options, including , dental, and vision plans, for the employee and their dependents, Health Spending Account (HSA), Life Insurance, and Long Term Disability. We also offer a 401k retirement plan with a generous employer match. Other benefits include Paid Time Off and Sick Leave.
The Director, Business Systems Operations is the senior strategic leader for the development, direction and day-to-day operations of the enrollment and encounter data teams; including the strategic oversight of all business system data operations that support the DHMSO customers. Remote working opportunities may be considered.
•Encounter data gathering, processing, submission, and analysis
•Eligibility processing and continuous performance monitoring for completeness and accuracy
•Claims system configuration
•EDI and development of a continuous process improvement environment supported by best practices
Bachelor's Degree in Business, Health Services Administration or related field.
5+ years of direct management experience in healthcare operations or healthplan setting and/or a combination of other relevant work experience, or healthcare experience
Designing, producing, and interpreting quantitative and qualitative analysis output
Advanced software/technical knowledge, which includes; understanding of health plan claims technology platforms, knowledge of SQL programming and managing/reviewing data in a healthcare
Master's Degree in Business, Health Administration or related field.
Preferred previous experience in a Managed Care, and/or Provider Services environment with experience with Medicaid and Medicare managed care plans.
Preferred QNXT software background
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