Manager Internal Pricing

At WebTPA, we have a history of providing innovative solutions/products to the market that meets the needs and wants of our customers. As we look to continue to grow and enhance our offerings, we are in search of an entry-level product manager to join our multi-disciplinary product development squad.

The Manager of Internal Pricing is responsible for the management of the Internal Pricing function within Pricing Configuration. This position will also be responsible for managing the detailed structures, setups, prioritization and roll out of configurations of employer groups. The manager will lead a team responsible for setting, monitoring, and making necessary adjustments to priorities for day-to-day operations to ensure the outlined metrics are met.

Essential Functions

• The functions listed represent the major duties of this role, additional duties may be assigned.

INTERNAL PRICING LEADERSHIP

• Manage the detailed structures, setups, prioritization and roll out of configurations of employer groups.
• Serve as SME and primary point of contact for escalated internal pricing related questions from team members, clients, or others.
• Manage new or renewal process by prioritizing activities of configurational change requests and statuses for the team to ensure that all changes are completed timely, accurately, and communicated with properly as necessary.
• Attend daily huddles with Senior Manager and team members.
• Communicate with all WebTPA departments and/or the client on escalated issues or questions.

TEAM WORKLOAD ASSIGNMENT

• Manage all the Internal Pricing team members for coordination of each of the different configurational elements of a client setup.
• Oversee daily activities, pull in additional resources as needed.
• Responsible for assigning client groups to team members; adjust where required.
• Establish team priorities and activities.
• Manage team workloads.

INTERNAL PRICING ADMINISTRATION

• Create workflows related to the team's processes.
• Verify accuracy of fee schedule and contract definitions
• Assist with ongoing maintenance of internal and external network setups.
• Provide clarification on contractual arrangements to internal departments, providers, and networks
• Assist with Provider EDI documentation and organization.
• Troubleshoot issues as they arise during projects.

TEAM MANAGEMENT

• Responsible for Internal Pricing team members including hiring, onboarding, performance management (performance appraisals, feedback, etc.), conducting 1:1 as needed, day-to-day communication, reward, and recognition.
• Handle timekeeper responsibilities, approve PTO, manage overtime.
• Provide coaching to new hires and team as needed to improve outcomes.

METRICS AND AREA PERFORMANCE MONITORING

• Identify and continually assess established metrics for quality, relevance, and accuracy.
• Monitor team member metrics and client performance guarantees.
• Identify and develop continuing improvement/training needs.
• Work with leads of all departments to ensure team members are meeting deadlines related to either new or change management impacts to configuration of the system.

Required Experience

• 3+ years related work experience. Experience Details: Working with health plans
• 1+ years direct supervisory/management experience
• Related Bachelor's degree or additional related equivalent work experience Health Administration preferred
• Effective in all the programs in MS Office and PC-based software skills (i.e., Word, Excel, PowerPoint)
• Excellent attention to detail and organizational skills Excellent verbal and written communication skills; excellent presentation skills
• Medical billing experience Extensive knowledge of CPT codes, HCPCs, ICD10
• Extensive knowledge of EDI claim processes Demonstrated experience in managing projects and/or improvement initiatives
• Experience with complex decision-making and problem solving
• Experience setting clear, actionable objectives and tactical plans for result attainment Experience in developing and maintaining effective working relationships

General Physical Demands

• Exerting up to 10 pounds of force occasionally to move objects.
• Jobs are sedentary if traversing activities are required only occasionally.

We are an Equal Opportunity/Protected Veteran/Disabled Employer committed to creating a diverse, inclusive, and equitable culture for our employees and communities