Managed Care Program Manager

Posted:
1/10/2025, 4:26:00 AM

Location(s):
Florida, United States ⋅ Bradenton, Florida, United States

Experience Level(s):
Junior ⋅ Mid Level ⋅ Senior

Field(s):
Product

Essential Functions
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Successful Candidate Requirements

  • Analyze large data on workers’ compensation managed care programs, including medical costs, claim outcomes, and vendor performance metrics
  • Identify trends, patterns, and insights to inform decision-making and program improvements
  • Design, develop, and maintain user-friendly dashboards to visualize key performance indicators (KPIs) and outcomes
  • Manage Workers Compensation Managed Care programs and vendor partner relationships
  • Provide strategic insights and recommendations to optimize managed care program performance
  • Collaborate with stakeholders to identify opportunities for cost savings, improved medical outcomes, and enhanced vendor efficiency
  • Work closely with cross-functional teams, including claims management, underwriting, and finance, to align analytics with organizational objectives
  • Utilize advanced data analysis and reporting tools (e.g., SQL, Tableau, Power BI, or similar)
  • Monitor vendor performance and compliance with service level agreements
  • Coordinate resolution of unresolved vendor related issues, questions and concerns

Qualifications:

  • Bachelor’s degree in business, management, data science, statistics, business analytics, or a related field
  • Minimum of 3-5 years of experience in data analysis, reporting, and dashboard development
  • Strong analytical and problem-solving skills with the ability to interpret complex data
  • Excellent verbal and written communications, with an ability to present findings to diverse audiences
  • Detail oriented with strong organizational and time management skills
  • Ability to analyze data, financial statements, program metrics
  • Proficiency in data visualization tools such as Tableau, Power BI, or similar
  • Advanced knowledge of SQL and other database querying tools.
  • Able to prioritize and ensure critical tasks are completed timely
  • Must demonstrate an ability to work independently
  • Proactive problem solver with ability to drive issues to resolution quickly
  • Experience in the property and casualty insurance industry, with a focus on managed care or workers compensation programs preferred

Communication Skills:

Effective with making complex technical information and recommendations understandable and clear to audiences with varied levels of technical knowledge

Listens effectively

Clearly expresses ideas, recommendations, etc. in writing

Technical Expertise:

Complete understanding of all Microsoft Office applications relevant for their area. Ability to navigate large volumes of data and create presentable summaries and recommendations. Ability to work with mathematical concepts such as probability and statistical inference, and fundamentals of formulas and equations.

Customer Service:

Responds timely and succinctly with all communication Builds credibility with internal and external customers

Creates customer satisfaction by providing value to stakeholders

Familiar with the company tools and is comfortable reviewing with all levels of management

Physical Capabilities:

Physical Work Demands:

  • Seeing/General and Close Vision
  • Hearing/Listening
  • Clear Speech- Complete
  • Touch: Dexterity, Hand, Finger, Repetitive Key Typing
  • Lifting up to 10 pounds
  • Pushing and Pulling
  • Bending
  • Sitting

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.



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