Description

　　Take on a significant role within a world-class health organization. Elevate the operational effectiveness of a complex health system. Take your professional expertise to the next level. You can do all this and more at UCLA Health.

　　As a key member of our Medicare Advantage Operations team, you will develop detailed requirements specifications to meet our business needs. This will involve working directly with and serving as a liaison between business units, external trading partners, IT, and support teams. You will:

　　Ensure functional and non-functional requirements are understood and implemented

　　Perform testing, design, and delivery requirements

　　Identify, analyze, quantify, and mitigate business risks

　　Deliver and update training documentation

　　Generate ad hoc reports to support the operations team

　　Salary Range: $71,500 - $154,900 AnnuallyQualifications

　　We're seeking a self-motivated, adaptable, customer-focused, results-driven individual with:

　　Required Bachelor's degree in business, information systems, healthcare, or a related field

　　Five or more years of experience managing enrollment, claims, or encounters in a Medicare or managed care environment required

　　Five or more years of experience with CMS processes required

　　Computer proficiency with Microsoft Office, SQL, and data visualization tools

　　Knowledge of encounter regulatory reporting and compliance requirements

　　Experience managing vendors to contractual requirements

　　Ability to research and resolve encounter issues

　　Understanding of the healthcare model, capitation, and other managed care IPA and provider reimbursement methodologies

　　Knowledge of physician/facility billing practices, CPT coding initiatives, ICD-10 coding standards, and revenue and HCPCS coding

　　Strong leadership, interpersonal, analytical, problem-solving, and prioritizing skills

　　Excellent oral and written communication skills

　　Ability to develop, implement, and evaluate methods and systems to improve efficiency

　　Ability to work well independently as well as part of a team

　　UCLA Health is a world-renowned health system with four award-winning hospitals and more than 260 community clinics throughout Southern California. We are also home to the David Geffen School of Medicine, a highly respected leader in the development of breakthrough medical research and outstanding clinical professionals. If you're looking to experience greater challenge and fulfillment in your career, you can at UCLA Health.

　　UCLA Health welcomes all individuals, without regard to race, sex, sexual orientation, gender identity, religion, national origin or disabilities, and we proudly look to each person’s unique achievements and experiences to further set us apart.