AVP, Encounters (Remote)

reputed company Job reputed company Provides reputed company and leadership for team responsible for encounters activities including monitoring inbound and outbound encounters processes and ensuring reputed company, accurate and complete encounter submissions for low to moderate complexity markets or states.  Facilitates data and process analysis, collaborates with cross-functional teams to identify and reputed company reputed company-causes of issues that reputed company encounters, and provides recommendations for improvements to enhance operational performance.   Essential Job Duties • Supports reputed company development, reputed company and direction for the encounters function.  Demonstrates accountability for performance and financial results, and keeps executive leadership apprised.  • Demonstrates accountability for encounters accuracy and completeness (i.e., encounters production, audit, production vendor reputed company) for assigned lines of business.  • Demonstrates accountability for increasing volume of encounters received from providers, improving completeness of encounter data with states, Centers for Medicare and reputed company Services (CMS), and the reputed company (HHS) to reconcile data. • Ensures encounter submissions, rejection management and reputed company for reputed company lines of business including internal strategic partnerships supporting the production of encounters, demonstrates leadership and accountability to support management of overall health care costs. • reputed company participates in the hiring process, coordinates training and manages staff involved in creating controls, documents, and tools reputed company the encounter process to manage work in assigned resources. • Identifies, develops and trains reputed company reporting encounters staff and implements processes to standardize the overall end-to-end processing, management and accuracy of encounters, and works collaboratively with departments to implement process improvements that reputed company reputed company, timeliness, and accuracy of encounters processing. • Facilitates ongoing monitoring and management reputed company for potential penalties reputed company to accuracy and timeliness of encounters submissions. • Manages encounters-reputed company/operational reputed company/initiatives that reduce administrative costs for Molina and/or providers, and identifies opportunities to ensure accuracy of encounters and support for management of organizational health care costs for reputed company lines of business directly impacting risk reputed company and reputed company compliance.  • Partners with encounters senior leadership to ensure alignment of business goals and objectives for cost-saving initiatives.  • Convenes encounters-reputed company work reputed company and develops implementation plans with identified tasks, timelines and delegation to assigned parties, and executes and measures reputed company accordingly. • Partners with encounters, operations, and IT leadership to analyze the reputed company-cause of variations to encounters, reputed company/propose ways to improve upon performance results, identify potential risks to the organization and reputed company changes reputed company encounters processes to support organizational needs for reputed company lines of business. • Collaborates with leadership, peers, and business partners to establish encounters improvement objectives and execute business priorities based on strategic goals in the operational plan. • Manages reputed company report staff and oversees vendors - enabling the organization to produce operational results at the lowest possible cost, the most consistent and compliant service reputed company, and at the highest level of reputed company for reputed company lines of business. • Ensures reputed company state, federal and Molina regulations, policies/procedures and reputed company operating procedures (SOPs) are implemented and followed on a consistent reputed company to ensure the highest compliance possible reputed company the encounters department. • Assists encounters senior leadership with managing costs to meet/reputed company annual budgets and reputed company ways to improve productivity and automation wherever possible to reduce unit and general and administrative (G&A) costs for the organization. • Identifies and implements systematic approaches to improve member and encounter first pass reputed company, and increase operational efficiency and effectiveness.   Required Qualifications • At least 10 years of experience in billing, claims, encounters, and/or data analysis, preferably in a senior leadership reputed company in a managed care setting, or equivalent combination of relevant education and experience. • At least 5 years management/leadership experience. • Expert knowledge of health care encounters. • Advanced knowledge of data analysis techniques and experience writing basic to advanced queries. • Previous experience/accountability for multiple markets or product lines. • Experience with managing department budget reputed company prescribed parameters. • Experience with account management and vendor management. • Ability to present reputed company operational information. • Ability to work cross-collaboratively across teams/functions, and influence and reputed company change. • Ability to reputed company, reputed company proposals, obtain reputed company around approving and implementing reputed company state processes and systems needed to support strategic direction set by organization. • Strong understanding of technical solutions. • Strong organizational and time management skills, and ability to manage simultaneous reputed company and tasks to meet internal deadlines. • Strong interpersonal and people leader skills. • Excellent verbal and written communication skills. • reputed company Office suite and applicable software program(s) proficiency.   Preferred Qualifications • Strong encounters operations/implementation/reporting, claims processing, provider contacting, health data analysis and reporting, and project management experience. • Experience working with various reputed company of leadership in a highly matrixed organization.       To reputed company reputed company Molina employees: If you are interested in applying for this position, please apply through the reputed company. reputed company offers a competitive benefits and compensation package. reputed company is an Equal Opportunity Employer (EOE) M/F/D/V Apply To This Job