Manager- Government Programs - Health Alliance Plan - Troy (full-time)
EDUCATION/EXPERIENCE REQUIRED:
- ONE of the following: 1. Licensed Social Worker with a Masters of Social Work; 2. Registered Nurse with minimum of 5 years' experience and Bachelor's Degree in related field.
- Two (2) years of administrative/management experience in an HMO, hospital or other health care agency.
- Two (2) years of experience in Managed Care.
- One (1) year experience in program planning and implementation that supports managed care principles.
- Strong leadership and delegation skills.
- Superior communication and conflict management skills allowing for the management of complex issues with effective diplomacy.
- Written and interpersonal communication skills.
- Strong problem solving, analytical and decision making.
- Strong organizational, planning and implementation.
- Well-developed time management and prioritization.
- Creative and resourceful.
- PC literacy. Demonstrated strong skill set in Microsoft Outlook, Word, Excel, Visio and Adobe programs.
- Strong skillset in electronic health record, case management.
- Ability to identify, assesses, and solve highly complex problems relating to team dynamics, benefits administration, and the delivery of health services.
- Knowledge of the health care industry, health maintenance organizations and third- party reimbursements.
- Knowledge of national standards related to case management goals, strategies and measurement.
- Medical management processes across the continuum of care.
- Standard medical procedures/practices and their application as well as current trends and developments in medicine and nursing.
- Disease processes and recognition of their distinctive cost patterns and unique range of available therapies and interventions.
- Local/national community resources.
- Medical terminology and ICD-10 and CPT coding.
- HMO, POS, PPO benefits and program requirements as relates to medical management preferred.
- State and Federal Medicaid and Medicare regulations.
- Demonstrated program success within a managed care organization.
- Demonstrated success of leadership skills and experience that emphasize trust, relationship building and professional growth of support staff.
CERTIFICATIONS/LICENSURES REQUIRED
- Licensed Social Worker (MSW) or Registered Nurse (BSN)
Overview
HAP is a Michigan-based, nonprofit health plan that provides health coverage to individuals, Â Â Â Â Â companies and organizations. A subsidiary of Henry Ford Health System, we partner with doctors, employers and community groups to enhance the overall health and well-being of the lives we touch. With more than 1,100 dedicated and passionate employees, our goal is to make health care easy for our members.
Â
Under the leadership of President and CEO Robert G. Riney, Henry Ford Health is a
$6 billion integrated health system comprised of six hospitals, a health plan, and 250+ sites
including medical centers, walk-in and urgent care clinics, pharmacy, eye care facilities and
other healthcare retail. Established in 1915 by auto industry pioneer Henry Ford, the health system
now has 32,000 employees and remains home to the 1,900-member Henry Ford Medical Group, one
of the nation’s oldest physician groups. An additional 2,200 physicians are also affiliated with the
health system through the Henry Ford Physician Network. Henry Ford is also one of the region’s Â
major academic medical centers, receiving between $90-$100 million in annual research funding and
remaining Michigan’s fourth largest NIH-funded institution. Also an active participant in medical
education and training, the health system has trained nearly 40% of physicians currently practicing
in the state and also provides education and training for other health professionals including nurses,
pharmacists, radiology and respiratory technicians. visit HenryFord.com.
Benefits
Whether it's offering a new medical option, helping you make healthier lifestyle choices or
making the employee enrollment selection experience easier, it's all about choice. Â Henry
Ford Health System has a new approach for its employee benefits program - My Choice
Rewards. Â My Choice Rewards is a program as diverse as the people it serves. Â There are
dozens of options for all of our employees including compensation, benefits, work/life balance
and learning - options that enhance your career and add value to your personal life. Â As an
employee you are provided access to Retirement Programs, an Employee Assistance Program
(Henry Ford Enhanced), Tuition Reimbursement, Paid Time Off, Employee Health and Wellness
and access to day care services at Bright Horizons Midtown Detroit, and a whole host of other
benefits and services. Employee's classified as contingent status are not eligible for benefits
Equal Employment Opportunity/Affirmative Action Employer
Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health System is
committed to the hiring, advancement and fair treatment of all individuals without regard to
race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,
weight, marital status, family status, gender identity, sexual orientation, and genetic information,
or any other protected status in accordance with applicable federal and state laws.