Manager of Cost Containment

City/State

Richmond, VA

Overview

Work Shift

First (Days) (United States of America)

Experience in management and knowledge of Claims Operations and Payment Integrity to include vendor management. Understanding of business rules associated with claims payment accuracy, COB and Medicare/ Medicaid required.

Job Summary

Works with leadership to define and stratify informatics requirements enabling customers to meet strategic goals and tactical objectives. Uses knowledge of Sentara's informatics infrastructure, analytical tools, information systems, and other data stores to construct analytical models to support program evaluation, operational and clinical analyses, and reporting for responsible business units or organizations. Designs and implements analytical solutions to improve processes, measure clinical quality goals, and meet regulatory reporting and analysis requirements. Scope of responsibilities includes: setting and managing strategic goals and tactical objectives; project management; and leadership support for customers. Oversees and directs dedicated analytical resources, providing mentoring, HR development and performance, manages vendor contracts and/or relationships to include contract negotiation. Relies on expert judgment to plan, execute and achieve goals and objectives, establishes and monitors customer service levels.

Project Management experience required. Quantitative Research Design experience required.

Qualifications:

BLD - Bachelor's Level Degree (Required)

Project Management Professional Certification (PMP) - Other/National

Clinical/Business Sectors, Healthcare

Skills

Active Learning, Active Learning, Active Listening, Communication, Complex Problem Solving, Coordination, Critical Thinking, Judgment and Decision Making, Leadership, Learning Strategies, Mathematics, Mgmt of Financial Resources, Mgmt of Material Resources, Mgmt of Staff Resources, Microsoft Excel, Microsoft Word, Monitoring, Persuasion, Project Management, Quality Control Analysis, Reading Comprehension, Science, Service Orientation, Social Perceptiveness, Speaking {+ 5 more}

Sentara Healthcare prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.

Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at ecfr.gov for further information. In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application.

In support of our mission "to improve health every day," this is a tobacco-free environment.