Manager, QNXT & Networx - Pricer Configuration
M
Molina Healthcare
📍 United States, NM, United States
Job Description
JOB DESCRIPTION Job Summary
Leads and manages team responsible for configuration activities including accurate and timely implementation and maintenance of critical information on claims databases, validation of data stored on databases, and adherence to health plan business and system requirements as it pertains to contracting, benefits, prior authorizations, fee schedules and other business requirements.
**Essential Job Duties**
+ Manages configuration team, and demonstrates accountability for team performance - including meeting or exceeding established performance targets; targets may be based upon specific health plan requirements, and/or federal/state requirements.
+ Represents as primary liaison with various functional areas/stakeholders (i.e. utilization management, claims, configuration, provider network, health plan leadership, etc.) to seek understanding of workflows and obtain required documentation for applicable audits.
+ Leads and organiz...
Leads and manages team responsible for configuration activities including accurate and timely implementation and maintenance of critical information on claims databases, validation of data stored on databases, and adherence to health plan business and system requirements as it pertains to contracting, benefits, prior authorizations, fee schedules and other business requirements.
**Essential Job Duties**
+ Manages configuration team, and demonstrates accountability for team performance - including meeting or exceeding established performance targets; targets may be based upon specific health plan requirements, and/or federal/state requirements.
+ Represents as primary liaison with various functional areas/stakeholders (i.e. utilization management, claims, configuration, provider network, health plan leadership, etc.) to seek understanding of workflows and obtain required documentation for applicable audits.
+ Leads and organiz...