Manager - Government Programs - Health Alliance Plan - Troy
EDUCATION/EXPERIENCE REQUIRED:
- ONE of the following:
- Licensed Social Worker with a Masters of Social Work;
- Registered Nurse with minimum of 5 years of 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).
Additional Details
This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described above.
Overview
Partnering with nearly 2 million people on their health journey, Henry Ford Health provides a full continuum of services at 250 care locations throughout southeast and south central Michigan. With 33,000 valued team members, Henry Ford is also among Michigan’s largest and most diverse employers. Our superior care and discoveries are powered by nearly 6,000 physicians, researchers and advanced practice providers. Learn more at 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. Henry
Ford Health has a new approach for its employee benefits program - My Choice
Rewards. My Choice Rewards is a program as diverse as the people it serves. 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. 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 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 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.