Department Name:
Program AdminWork Shift:
DayJob Category:
General Operations
The future is full of possibilities. At Banner Health, we’re excited about what the future holds for health care. That’s why we’re changing the industry to make the experience the best it can be. If you’re ready to change lives, we want to hear from you.
Banner Health has been recognized by Becker’s Healthcare as one of the 150 top places to work in health care. In addition, we recently made Newsweek’s list of America’s Greatest Workplaces 2023 for Diversity. These recognitions reflect Banner Health's investment in team members' professional development, wellness benefits, and continued education. It highlights our commitment to advocating for diversity in the workplace, promoting work\-life balance, and boosting employee engagement.
In the role of Senior Manager, Government Programs, you will serve as a key resource responsible for ensuring organizational compliance with Medicare and Arizona Medicaid regulations. This includes monitoring regulatory updates, interpreting requirements, and effectively communicating necessary changes across departments. You will oversee the alignment of processes, provider\-related activities, and contractual obligations to ensure adherence to all applicable standards. A significant aspect of this position involves cross\-functional coordination to track the progress of strategic initiatives, proactively identify potential risks, and escalate issues to leadership as needed. You will also participate in regulatory discussions, develop and deliver training on policy updates, and support ongoing oversight of provider manuals, network compliance requirements, and responses to AHCCCS related inquiries. The ideal candidate will have approximately three years of experience with Arizona Medicaid and Medicare Advantage programs with a primary focus on provider network requirements enabling them to contribute effectively in a fast\-paced, highly regulated environment.
The role is Monday through Friday 8 hour shifts and is primarily remote with some on\-site requirements in Phoenix and Tucson.
Banner Plans \& Networks (BPN) is an accountable care organization that joins Arizona's largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. Through BPN, known nationally as an innovative leader in new health care models, insurance plans and physicians are coming together to work collaboratively to keep members in optimal health, while reducing costs.
POSITION SUMMARY
This position is responsible for assisting with ensuring operational support for all programmatic functions for Medicaid and Medicare Programs that will drive superior product performance. The position will provide ongoing support to ensure compliance and operational performance of new and existing programs and projects. This position works both independently and collaboratively with all health plan, network, or organizational functional areas with the purpose to support the development, implementation, maintenance, monitoring, and continuous improvement of Medicaid and Medicare Programs. The Government Programs Senior Manager will work closely with the Health Plan, Network, or Other Entity Leadership to create a metric driven and results oriented reporting environment to manage the strategic and tactical side of the business. This position will have responsibility for supervising a support staff.
CORE FUNCTIONS
1\. Ensures all Medicare and Medicaid regulatory and policy guidance are disseminated and implemented in a timely manner with the business owners and partners to ensure that such guidance is strictly adhered to, implemented and monitored and that evidence of implementation is verified and documented.
2\. Manages and oversees the product development strategic plan which includes developing the initiatives with each matrix area and setting up follow up meeting and tracking documents to ensure we are achieving towards the agreed upon goals.
3\. Manages, tracks, and oversees compliance with contract deliverable requirements. Assists all functional areas with ensuring they are aware of the most current deliverables are on track and assist the functional areas with any challenges or items at risk by raising those concerns to executive leadership
4\. Attends Medicare and Medicaid regulatory calls and meetings and disseminates and trains on appropriate material from the calls/meetings.
5\. Assists with researching and tracking the Medicaid and Medicare regulatory environment and initiatives in collaboration with Health Plan, Network, or Entity Administrators, Senior Leaders, and Compliance Departments. Ensures the regulatory reporting requirements, training and oversight for the Medicare and Medicaid LOBs are timely, accurate and compliant.
6\. Collaborates with other Health Plan Departments to ensure effective partnerships are developed and maintained. Maintains knowledge and communicates trends within our markets and the industry overall.
MINIMUM QUALIFICATIONS
Must possess knowledge as normally obtained through the completion of a bachelor’s degree in health care administration, finance administration or organizational/project management.
Three or more years of Medicare Advantage equivalent combination of operational work experience. The work requires a high degree of organization, the ability to manage time and resources effectively, and the self\-starter ability to work independently to achieve goals. Effective customer service and interpersonal relations skills are necessary. The ability to communicate effectively verbally, in writing and through common computer software is required.
Excellent Microsoft Office Suite Skills including Visio with a focus on developing dashboards and presentations. Excellent Power Point and Excel skills needed and MicroSoft Project.
PREFERRED QUALIFICATIONS
Additional related education and/or experience preferred.
Estimated Pay Range:
$37\.14 \- $61\.90 / hour Banner Health is committed to pay equity and transparency. The posted compensation range is a reasonable estimate that extends from the lowest to the highest pay Banner Health in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. This range is based on possible base salaries and does not include the value of our total rewards package. Actual pay determined at offer will be based on years of relevant work experience, education, certifications, skills, and geographic location, along with a review of current employees in similar roles to ensure pay equity is achieved and maintained.
EEO Statement:
EEO/Disabled/Veterans
Our organization supports a drug\-free work environment.
Privacy Policy:
Privacy Policy