1199SEIU Family of Funds - New York, NY

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  • Supervise the workflow and day-to-day activities of the Data Management (DM) team; provide operational and technical support as it relates to correspondence and report generation, Medical Claims Processing (QNXT) authorization module, computer equipment, software and hardware applications
  • Measure and monitor staffing levels, assign duties and delegate responsibilities as appropriate
  • Prepare weekly and monthly reports on staff activity, complete performance evaluations, track time and attendance, perform labor management activities, and remedial to progressive disciplinary action in accordance with Human Resources guidelines and provisions of the Collective Bargaining Agreement (CBA)
  • Develop and implement Quality Assurance Programs; conduct and review bi-monthly quality audits to ensure accurate understanding and adherence to policies and procedures
  • Assist with developing new and existing workflow processes based on departmental needs
  • Train and educate staff on departmental workflow and protocols; review and maintain departmental manuals regularly for immediate updates and modifications
  • Troubleshoot and resolve issues with vendors and providers; assist with urgent, expedited and complex cases that require management level problem solution; act as liaison with other departments and establish and maintain communications with various areas of the Fund
  • Collect, analyze data and create reports for clinical and financial outcomes
  • Perform additional duties and projects as assigned by management

  • Bachelor’s Degree in Computer Science, Business Administration , Health Care or equivalent years of work experience; plus
  • Minimum of three (3) years database management experience ; to include one (1) year experience in leadership role
  • Advanced knowledge of Microsoft Office (Access, Word, Excel, and Outlook) and Intermediate knowledge of SQL required
  • Good project management skills for implementation of new programs and sustainability of current programs
  • Knowledge of eligibility guidelines and benefit entitlements, medical claims processing and benefit administration systems (QNXT and Vitech V3) for 1199SEIU National Benefit and Pension Funds and 1199SEIU Greater New York Benefit Fund and Homecare Fund preferred
  • Ability to prioritize, multi-task and work well in a fast-paced, high volume environment; must be able to work well independently and in teams
  • Excellent analytical, interpersonal and communications skills – oral, written and listening
  • Good problem-solver, must be detail oriented, able to troubleshoot and follow guidelines
  • Excellent written and verbal communication skills
  • Demonstrated management skills and leadership qualities with good decision making abilities
  • Must meet performance standards including attendance and punctuality