Supervisor Record Retrieval - WAH

Profile

Description

Our search is focused on identifying a people and process leader who will assist with ownership of retrieval activities required to meet Risk Adjustment, Quality Measures and HEDIS goals. This role reports to the MRA Director and will work closely with the Director and retrievals team to ensure all retrieval goals are met. The successful candidate should be able to demonstrate experience in putting together an action plan, implementation and monitoring.

In addition, he/she should be able to commit to cultivating internal and external business relationships to achieve agreed-upon results. An ideal candidate will be recognized for excellent verbal, visual and written communication skills, strong analytical skills, ability to manage competing priorities, and attention to detail.

Position may require travel 10-15% of the time.

Responsibilities

Our search is focused on identifying a people and process leader who will assist with ownership of retrieval activities required to meet Risk Adjustment, Quality Measures and HEDIS goals. This role reports to the MRA Director and will work closely with the Director and retrievals team to ensure all retrieval goals are met. The successful candidate should be able to demonstrate experience in putting together an action plan, implementation and monitoring.

In addition, he/she should be able to commit to cultivating internal and external business relationships to achieve agreed-upon results. An ideal candidate will be recognized for excellent verbal, visual and written communication skills, strong analytical skills, ability to manage competing priorities, and attention to detail.

Position may require travel 10-15% of the time.

Actual role function examples:

Develop a comprehensive understanding of Humana's retrieval policies, strategy and system tools

Management of CA, NV and HI record retrieval associates and activities

Coordinate and provide day-to-day oversight of associates and ensure consistency in execution

Ensure engagement of a team of field associates

Timely and effective resolution of any retrieval issues

Ensure accuracy of provider data in system tools through analysis, reconciliation and tracking of pursuit lists

Define and create retrieval workflows and processes

Hire and train retrieval associates

Ensure adherence of retrieval team to all enterprise policies and guidelines such as but not limited to those related to travel, PHI security, privacy and confidentiality

Performs other relevant duties deemed necessary to achieve department and company-wide goals

Requirements:

Bachelor's Degree or equivalent experience

Prior supervisory experience; knowledge of risk adjustment, quality measures and HEDIS processes and/or medical clinic operations is preferred

Knowledge of EMR systems

Prior experience working in a cross-functional team

Advanced facilitation and presentation skills to include online delivery (Webex)

Proficiency in Microsoft Office tools including Word, Excel, Outlook, Teams and PowerPoint

Demonstrated ability to manage competing priorities and to effectively manage projects simultaneously

Demonstrated ability to adapt quickly to change

Willingness and ability to travel at a rate of approximately 10-15%, including overnight, if necessary

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com