Providence Health & Services Medicare Benefit Manager in Beaverton, Oregon
Providence is calling a Medicare Benefit Manager to Providence Health Plans in Portland, OR.
In this position you will have the following responsibilities:
Detailed scenario analysis for Medicare portfolio planning including benefits that cross lines of business
Detailed understanding of Product, Membership, Claims, Pricing, billing, etc. configuration and workflow
Detailed benefit categorization and alignment for bid submission
Support Medicare Part D (MPD) audit and review
Detailed benefit support for material development, review and publication
Manage annual benefit change control process
Support benefits management in relation to regulatory mandates, competitive environments, risk management, price impact, medical policy and operational feasibility
Support training process and materials creation regarding Medicare benefits
Develop business decision documentation and tracking process related to benefits administration
Maintain functional working relationships with vendors to complete deliverables for the Medicare product annual life-cycle.
Required qualifications for this position include:
Bachelor of Science (BS) in Business or Healthcare Administration -or-
5-7 years of relevant Centers for Medicare& Medicaid Services (CMS) Medicare work experience
5-7 years of experience working with benefits in a fast-paced Medicare product annual life-cycle capacity
Proven experience working with teams and staff of various capacities, approach and work-styles
Experience working in an environment with shifting priorities requiring flexibility and the ability to prioritize work
Experience supporting scenario and impact analysis in support of annual strategic benefit planning and change impact
Working knowledge of Medicare operations and life-cycle
Working knowledge of CMS regulation and compliance
Both broad and deep experience with current Medicare benefits, product portfolio and annual life-cycle process.
Understanding of strategic and tactical directions of Providence Health Plans (PHP)
Preferred qualifications for this position include:
- Experience working with Facets
About Providence in Oregon
As the largest healthcare system and largest private employer in Oregon, Providence offers exceptional work environments and unparalleled career opportunities.
The Providence Experience begins each time our patients or their families have an encounter with a Providence team member and continues throughout their visit or stay. Whether you provide direct or indirect patient care, we want our patients to feel that they are in a welcoming place where they can be comfortable and free from anxiety. Our employees create the Providence Experience through simple, caring behaviors such as acknowledging and welcoming each visitor, introducing ourselves and Providence, addressing people by name, providing the duration of estimated wait times and updating frequently if timelines change, explaining situations in a way that puts patients at ease, carefully listening to their concerns, and always thanking people for trusting Providence for their healthcare needs. At Providence, our quality vision is simple,
"Providence will provide the best care and service to every person, every time."
Providence is consistently ranked among the top 100 companies to work for in Oregon. It is also home to two of our award-winning Magnet medical centers. Providence hospitals and clinics are located in numerous areas, ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland. If you want a vibrant lifestyle while working with a team highly committed to the art of healing, choose from our many options in Oregon.
We offer a full comprehensive range of benefits - see our website for details
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Business Professional
Req ID: 211484