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Posted : Wednesday, December 06, 2023 01:22 PM
* Position is eligible for Remote / Work from Home opportunity *
Department: Provider Education
Telecommuting Eligible: Yes
Job Grade: E13
Notice of Collection & Privacy Policy for Applicants Residing in California: California Applicant Privacy Policy | Noridian (noridiansolutions.
com) Job Title Manager Operations Job Summary The Operations Manager provides guidance, leadership, planning, and reporting to the assigned business unit.
This position ensures the assigned business unit is administering the organizations contracts with the best possible service while maintaining contract expectations and within budget constraints and optimizing staffing levels.
Essential Functions Key Duties/Responsibilities/Accountabilities Coaches and develops staff by encouraging growth and ensuring staff are meeting performance expectations Ensures the organization meets all contractual expectations Manages budgets and works to meet requirements with available funding Ensures responsiveness to audit findings and implements timely changes as appropriate Ensures strong internal controls and compliance programs within responsible operations Initiates process improvements and technology implementation Initiates disciplinary action when performance does not meet expectations Leads by example by promoting teamwork, recognition, and leadership while demonstrating the company values May provide guidance on evaluating the circumstances of cases related to suspected fraud to support potential investigations and fraud prevention procedures Assist in organizational and corporate growth opportunities Responds to and implements changes in a flexible, positive manner Participates as the area subject-matter expert during business development activities as needed Non-Essential Duties and Functions Other duties as assigned Minimum Qualifications Bachelor's degree in Business Administration, Management, or closely related field or equivalent work experience as determined by HR 4 years' experience managing staff Knowledge of management theories and practices Understands computer information systems Knowledge of basic accounting practices Specific contracts may require: Bachelor's degree in Business Administration, Management or closely related field and 10 years' management experience Specific contracts may require: Compliance, Investigation and Fraud Prevention experience required.
Certified Fraud Examiner (CFE) or Accredited Healthcare Fraud Investigator (AHFI) required.
Specific contracts may require: Experience required in Medicare Hearings & Appeals.
Be familiar with all current policies and regulations.
42 CFR 498 and PIM.
Specific contracts may require: 10+ years of professional experience with 3 years managing complex system and workflow.
Requires master's degree or additional 4-year equivalent experience as determined by the HR.
IME Key Personnel requires: 4 years' experience managing claims processing operations and personnel for a Medicaid state entity, fiscal agent, or private sector health care payor, including a minimum of two years MMIS experience MAC A/B PE Key Personnel requires: Bachelor's degree and 3 years' experience with Medicare Fee-for-Service provider enrollment operations and 5 years of supervisory/team lead experience for Medicare Part A or Part B operations.
Bachelor's degree may be substituted with 10 years' experience with Medicare Part A or B operations.
MAC A/B Claims Key Personnel Requirements: 3 years work experience with Medicare or Medicare-equivalent Fee-for-Service claims processing operations.
Prior experience with both Medicare Part A and Part B claims processing operations is required Preferred Qualifications Above requirements and the following: Bachelor's degree in Business Administration or Management 5 years' experience managing staff Strong written and oral communication skills Ability to motivate and manage a large group of people Ability to direct and maintain a productive and conducive working environment Ability to coordinate activities among co-workers Ability to develop problem solving skills within staff Strong analytical skills Environment and Cognitive/Physical Demands Office Environment Ability to read, hear, speak, keyboard, reason, communicate effectively and problem solve Requires prolonged sitting and telephone use Requires the use of office equipment such as computer terminals, telephones, copiers, and printers Infrequent lifting to 15 pounds Infrequent stooping Segregation of Duties Every employee is responsible to perform their duties and responsibilities in accordance with Noridian values, policies and procedures, including but not limited to: Segregation of Duties Principles, HIPAA, Security and Privacy, CMS requirements, the Noridian Compliance Program and any other applicable laws, rules and regulations.
Statement of Other Duties This document describes the essential functions, requirements, and responsibilities of this job, and is not intended to be a complete list of all tasks and functions.
Employees may be requested to perform job related tasks other than those specifically listed in this description and may be required to perform any task requested by the supervisor or management.
Total Rewards Package: Health, Dental and Vision Insurance, Voluntary Insurance Plans, Health Savings and Flexible Spending Accounts, 401k and Company Match, Company-paid Life Insurance, Education Assistance Program, Paid Sick Leave, Paid Holidays, Increasing PTO Accrual Plan, Medical/Parental/Disability Leave, Workers Compensation, Retiree Benefits, Severance Package, Employee Assistance Program, Financial and Health Wellness Benefits, Casual Dress, Open Office Setting, and Online Learning System.
CMS Access Compliance and Regulation Contingency Statement Some positions require compliance with (i) federal and agency specific regulations and related clauses included in Noridian's prime contracts with the Government, (ii) background checks, and (iii) eligibility for a government-issued identification card.
Equal Employment Opportunity Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities as well as Sexual Orientation or Gender Identity.
Below is the salary range for potential new hires.
Salary Range: $68,928.
86 - $113,369.
53 Other Compensation: Self-Managed PTO (if applicable), Incentive Plan Lifestyle Benefit: $50/month This job will be closed 02/09/2024 at 8:00AM CST.
No further applications will be considered.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant.
However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information.
41 CFR 60-1.
35(c)
com) Job Title Manager Operations Job Summary The Operations Manager provides guidance, leadership, planning, and reporting to the assigned business unit.
This position ensures the assigned business unit is administering the organizations contracts with the best possible service while maintaining contract expectations and within budget constraints and optimizing staffing levels.
Essential Functions Key Duties/Responsibilities/Accountabilities Coaches and develops staff by encouraging growth and ensuring staff are meeting performance expectations Ensures the organization meets all contractual expectations Manages budgets and works to meet requirements with available funding Ensures responsiveness to audit findings and implements timely changes as appropriate Ensures strong internal controls and compliance programs within responsible operations Initiates process improvements and technology implementation Initiates disciplinary action when performance does not meet expectations Leads by example by promoting teamwork, recognition, and leadership while demonstrating the company values May provide guidance on evaluating the circumstances of cases related to suspected fraud to support potential investigations and fraud prevention procedures Assist in organizational and corporate growth opportunities Responds to and implements changes in a flexible, positive manner Participates as the area subject-matter expert during business development activities as needed Non-Essential Duties and Functions Other duties as assigned Minimum Qualifications Bachelor's degree in Business Administration, Management, or closely related field or equivalent work experience as determined by HR 4 years' experience managing staff Knowledge of management theories and practices Understands computer information systems Knowledge of basic accounting practices Specific contracts may require: Bachelor's degree in Business Administration, Management or closely related field and 10 years' management experience Specific contracts may require: Compliance, Investigation and Fraud Prevention experience required.
Certified Fraud Examiner (CFE) or Accredited Healthcare Fraud Investigator (AHFI) required.
Specific contracts may require: Experience required in Medicare Hearings & Appeals.
Be familiar with all current policies and regulations.
42 CFR 498 and PIM.
Specific contracts may require: 10+ years of professional experience with 3 years managing complex system and workflow.
Requires master's degree or additional 4-year equivalent experience as determined by the HR.
IME Key Personnel requires: 4 years' experience managing claims processing operations and personnel for a Medicaid state entity, fiscal agent, or private sector health care payor, including a minimum of two years MMIS experience MAC A/B PE Key Personnel requires: Bachelor's degree and 3 years' experience with Medicare Fee-for-Service provider enrollment operations and 5 years of supervisory/team lead experience for Medicare Part A or Part B operations.
Bachelor's degree may be substituted with 10 years' experience with Medicare Part A or B operations.
MAC A/B Claims Key Personnel Requirements: 3 years work experience with Medicare or Medicare-equivalent Fee-for-Service claims processing operations.
Prior experience with both Medicare Part A and Part B claims processing operations is required Preferred Qualifications Above requirements and the following: Bachelor's degree in Business Administration or Management 5 years' experience managing staff Strong written and oral communication skills Ability to motivate and manage a large group of people Ability to direct and maintain a productive and conducive working environment Ability to coordinate activities among co-workers Ability to develop problem solving skills within staff Strong analytical skills Environment and Cognitive/Physical Demands Office Environment Ability to read, hear, speak, keyboard, reason, communicate effectively and problem solve Requires prolonged sitting and telephone use Requires the use of office equipment such as computer terminals, telephones, copiers, and printers Infrequent lifting to 15 pounds Infrequent stooping Segregation of Duties Every employee is responsible to perform their duties and responsibilities in accordance with Noridian values, policies and procedures, including but not limited to: Segregation of Duties Principles, HIPAA, Security and Privacy, CMS requirements, the Noridian Compliance Program and any other applicable laws, rules and regulations.
Statement of Other Duties This document describes the essential functions, requirements, and responsibilities of this job, and is not intended to be a complete list of all tasks and functions.
Employees may be requested to perform job related tasks other than those specifically listed in this description and may be required to perform any task requested by the supervisor or management.
Total Rewards Package: Health, Dental and Vision Insurance, Voluntary Insurance Plans, Health Savings and Flexible Spending Accounts, 401k and Company Match, Company-paid Life Insurance, Education Assistance Program, Paid Sick Leave, Paid Holidays, Increasing PTO Accrual Plan, Medical/Parental/Disability Leave, Workers Compensation, Retiree Benefits, Severance Package, Employee Assistance Program, Financial and Health Wellness Benefits, Casual Dress, Open Office Setting, and Online Learning System.
CMS Access Compliance and Regulation Contingency Statement Some positions require compliance with (i) federal and agency specific regulations and related clauses included in Noridian's prime contracts with the Government, (ii) background checks, and (iii) eligibility for a government-issued identification card.
Equal Employment Opportunity Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities as well as Sexual Orientation or Gender Identity.
Below is the salary range for potential new hires.
Salary Range: $68,928.
86 - $113,369.
53 Other Compensation: Self-Managed PTO (if applicable), Incentive Plan Lifestyle Benefit: $50/month This job will be closed 02/09/2024 at 8:00AM CST.
No further applications will be considered.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant.
However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information.
41 CFR 60-1.
35(c)
• Phone : NA
• Location : 901 40th Street South, Fargo, ND
• Post ID: 9071185060
