Manager, Eligibility Operations

Posted:
10/16/2024, 5:35:28 AM

Experience Level(s):
Senior

Field(s):
Data & Analytics ⋅ Operations & Logistics

  • Manage team of eligibility processors and business analyst.
  • Oversee inventory and workflows for eligibility processors.
  • Oversee RITA ticket inventory and timeliness.

Responsible for the direction and oversight of reporting and analytics. Develops and manages all critical reports and provides general analysis needed to support strategic decision making. Ensures strategic objectives are met by providing necessary information to business operations, finance, quality, compliance, procurement and clinical functional areas. Works closely with end users and business leaders to understand functional requirements for reporting solutions. In addition, monitors critical metrics and informs leadership of potential risks. Works collaboratively with other analytics teams to insure accurate and timely delivery of reports. Ensures all resources are working up to their maximum potential to meet regulatory, customer and internal reporting requirements, meeting all deadlines and following all of the proper policies and procedures. In addition, leads and possibly performs programming and analysis as needed. Requires working knowledge of programming, data mining techniques, application development, and data analysis. Additional duties include providing guidance and mentoring to staff as required, and working with the business owners to set priorities of projects and associated tasks.
  • Works across business areas as the primary focal point to lead the development and management of all internal/external reporting containing critical operational, financial, quality, and compliance metrics needed to support the business. This includes estimates of feasibility, time and effort of tasks and providing updates to both the user community and necessary staff. Monitors projects, determines potential problems and guides them to a successful completion. 
  • Directs the development of tactical and strategic plans to satisfy technical business needs. Leads standardization of data processes to ensure efficient practices that are best in class.  
  • Monitors data and reporting projects, determines potential problems and guides them to a successful completion. Focuses on a larger picture, and pushes toward the strategic vision for their products. 
  • Leads changes and enhancements to business processes, policies, and system infrastructure including project management when needed. Directs and manages business process re-engineering associated with existing, developing and implementation of systems. 
  • Builds a strong local reporting and analytics team through formal meetings, training, coaching, mentoring, and other development techniques. 
  • Performs programming and analysis as needed. 

Other Job Requirements

Responsibilities

Undergraduate degree ideally in a quantitative field such as Mathematics, Computer Science or related degree. 
5+ years of direct, relevant experience.
May consider candidates without a Bachelor's degree who have an additional 4 years of direct experience for a total of 9 years minimum. 
Expert level knowledge of SQL, Qlikview, Tableau or similar business intelligence tools 
MS Suite power user with expertise in visualization tools. 
Required experience in a production environment setting up processes to be maintainable and scalable. 
Strong analytical and problem solving skills with the ability to work with diverse groups of internal clients while maintaining high degrees of accuracy and precision. 
Ability to think creatively; highly-driven and self-motivated. 
Ability to drive results and deliver on multiple tasks. 
Experience building, developing and managing high-performing teams. 
Proven track record of defining and executing key analysis with minimal supervision 

General Job Information

Title

Manager, Eligibility Operations

Grade

29

Work Experience - Required

Analytics/Informatics, Supervisory

Work Experience - Preferred

Healthcare

Education - Required

A Combination of Education and Work Experience May Be Considered., Bachelor's

Education - Preferred

License and Certifications - Required

License and Certifications - Preferred

Salary Range

Salary Minimum:

$93,955

Salary Maximum:

$159,725

This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.

This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.

Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.