A rewarding career that fits your life. Those who have joined the Banner mission come from all walks of life, united by the common goal: Make health care easier, so life can be better. If changing health care for the better sounds like something you want to be part of, apply today.
Looking for a dynamic and eager business professional with an interest in Health Plan Operations performance monitoring. Position will work closely with all areas of the Health Plan, including regular exposure to executive leadership. Flexible hours to meet the needs of the right candidate and full time remote options.
Your pay and benefits are important components of your journey at Banner Health. Banner Health offers a variety of benefits to help you and your family. We provide health and financial security options so you can focus on being the best at what you do and enjoying your life.
Banner University Health Plans (BUHP) manage a variety of health plans. Our mission is to advance health and wellness through education, research and patient care. About Banner Health Banner Health is one of the largest, nonprofit health care systems in the country and the leading nonprofit provider of hospital services in all the communities we serve. Throughout our network of hospitals, primary care health centers, research centers, labs, physician practices and more, our skilled and compassionate professionals use the latest technology to make health care easier, so life can be better. The many locations, career opportunities, and benefits offered at Banner Health help to make the Banner Journey unique and fulfilling for every employee.
POSITION SUMMARY This position provides technical, clerical and operational support to the Progr Mgr, Health Plans in the development, implementation, maintenance and continuous improvement of new and extant Medicare programs and projects. Provides the operational support of Medicare Programs ongoing programs. Disseminates HPMS memos, maintains files, database and documentation of project implementation and verifications, submits reports to CMS and maintains all documentation. Provides administrative support to the annual CMS Bid submission, periodic Service Area Expansions, Call letter implementation, annual readiness review attestation, etc.). Reviews submitted materials for quality, accuracy and completeness and making recommendations to Manager regarding the acceptance and/or modifications necessary for these materials. Assists with identifying, compiling and disseminating legislative and regulatory trends and initiatives that impact Medicare, Medicare Advantage and Medicare Advantage Dual SNP programs. Serves as a first line resource for navigating CMS regulations, sub-regulator guidance and policies, and is responsible for recommending and advising the functional areas and the Manager regarding impact on operations.
CORE FUNCTIONS 1. Disseminates CMS regulatory, sub-regulatory and policy guidance in a timely manner and receives verification and documentation that such guidance is strictly adhered to and implementation verified. Independently reviews evidence of implementation and advises functional areas and the Manager on the veracity of the evidence. This includes but is not limited file/administrative management of HPMS Memos, the annual Call Letter, Managed Care Manual Chapter changes and updates, the annual readiness checklist.
2. Assists with the annual CMS Bid process. Performs independent QA of the submission and advises Manager on the results with recommendations of corrections as appropriate.
3. Provides technical and operational support and processing of the annual Service Area Expansion process as necessary. Performs independent QA of the submission and advises Manager on the results with recommendations of corrections as appropriate.
4. Submits or monitors all required materials and data to CMS via HPMS. Collects materials from the functional area (in which case the Manager will facilitate and verify) and assists as necessary. Performs independent QA of the submission and advises Manager on the results with recommendations of corrections as appropriate. This includes but is not limited to formulary submission, annual website update, marketing materials, LIS match Rates, Monthly Encounter Data (formerly RAPS), Part C and Part D Reporting.
5. Provides support for the following: the development of the New Member Notifications (e.g. ANOC, EOC), development and production of all member materials, maintenance of most current model member communications, attends all relevant CMS user group calls, project management of the annual Data Validation process.
6. Serves as resource for Annual 5 Star plan. Compiles and disseminates legislative and regulatory trends and initiatives that impact Medicare, Medicare Advantage and Medicare Advantage Dual SNP programs. Assists with project management and monitoring of Model of Care requirements and processes.
7. Assists with the production of Monthly Operational Dashboard (actual production of data comprising dashboard is the responsibility of the functional areas). Assists with ensuring functional areas are compiling and reporting the data that comprise the Monthly Medicare Compliance Dashboard.
8. Assists with the annual Medicare Product implementation workgroup.
9. This position works under supervision, prioritizing data from multiple sources to provide quality care and support. Incumbents work in a fast-paced, sometimes stressful environment with a strong focus on customer service. Interacts with staff at all levels throughout the organization.
Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all customers of Banner Health with an excellent service experience by consistently demonstrating our core and leader behaviors each and every day.
Knowledge, skills and abilities as normally obtained through the completion of a bachelor's degree and one year experience working in an office environment.
Knowledge of record management best practices, project coordination and database development and maintenance and knowledge of Medicare and Medicaid managed care practices and regulations.
Skill in communicating with all levels of the organization, oral and written communication skills, and skill in building and maintaining interpersonal relationships. Skill in the use of computer applications including Microsoft office products and EXCEL. Ability to organize and execute programs, work independently ensuring all deadlines are met. Ability to be flexible in order to work on a variety of initiatives simultaneously under tight time constraints and to work cross functionally across the organization and to use critical thinking in resolving problems and conflicts. Ability to grasp new knowledge and concepts quickly and apply them
One to two years experience of health care administrative support experience, one to two years of other administrative support experience, one year of project coordination/project management experience preferred.
Additional related education and/or experience preferred.
What might draw you to Banner Health? A great health care career, of course—and a great place to live, no matter what stage of life you’re in. With facilities across the West, there is a health care career for everyone, from big city living in the Phoenix area to friendly small towns in the mountains and plains. As one of the largest nonprofit health systems in the country, Banner Health offers both the stability that comes with success and the possibility of exploring new areas of the country. If you’re looking to be a key contributor to a forward-looking organization, you’ll experience a wide variety of professional advantages:
Our expansive system offers you an unmatched variety of clinical settings – from large urban trauma center to small rural hospital, ambulatory to home health.
Our commitment to healthcare innovation means you always have the latest technologies at your fingertips to help you provide the finest care possible.
The size, success and growth of our system provide you with the stability and options to pursue your desired career path.
Competitive compensation and comprehensive benefits offer you options to complement your unique needs.