Robert Half International Healthcare Services Director in Irving, Texas
Robert Half Technology's client in Irving, TX is seeking a Director that will lead and direct the Technical Research, Quality Assurance, and Compliance teams for one of their biggest and longest running accounts. This includes project management, client management, and development by following standard SDLC Principles.
At a high level, they need someone who understands medicare claims, understands the claims processing/data flow, understands benefit plan design and how that impacts those in the claims flow, and speak to the technical aspects of that operation.
Must be able to support both external client system enhancement requests and internal requests coming in from Claims Operations.
Responsibilities also include enhancements to our Business Intelligence platform used for client and Fraud, Waste and Abuse (FWA) purposes.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions
Experience with Third Party Administrator IT and Claims Operations supporting Group Health Plans
Medicare Part A and B claims processing
CMS Fee Schedule administration
Strong in reporting. Excel is a must have. SQL is a plus.
Medicare guru – Medicare claims, operations, processes, work flows, etc.
Project management, client management, and leadership experience
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Questions? Call your local office at 1.888.490.4429. All applicants applying for U.S. job openings must be authorized to work in the United States. Benefits are available to temporary professionals. Visit https://roberthalf.gobenefits.net/ for more information.
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