Job Opportunities in United States
November 6, 2024
PacificSource Health Plans
Portland
FULL TIME
IT Manager, Medical Management
Looking for a way to make an impact and help people?
Join Pacific Source and help our members access quality, affordable care!
Pacific Source is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, national origin, sex, sexual orientation, gender identity or age.
Diversity and Inclusion: Pacific Source values the diversity of the people we hire and serve. We are committed to creating a diverse environment and fostering a workplace in which individual differences are appreciated, respected and responded to in ways that fully develop and utilize each person’s talents and strengths.
The IT Manager’s role is to plan, coordinate, and manage activities related to the design, development / integration, and implementation of information systems, software applications, and databases. The IT Manager is also responsible to maintain, support, and upgrade existing systems and applications. This individual will apply proven communication skills, problem-solving skills, and knowledge of best practices to guide team of IT professionals on issues related to the design, development / integration, and deployment of mission-critical information and software systems. Specific Responsibilities for Medical Management IT Manager: As Manager of the Medical Management team, this Manager’s responsibilities include management of Medical Management platforms and systems, data management, electronic health record management, and other aspects of health services related systems. In addition to responsibility for in-scope platforms, such as Epic Payer Platform and Casetrakker, this Manager’s position is charged with driving strategies, development, and solutions in support of continual improvements to provider and member data quality, integrity, and usability in the health services arena. This position requires close partnership with business teams, external stakeholders, and key vendors to ensure that platforms and data resources remain aligned with the current and future needs of the organization.
Essential Responsibilities:
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Manage the development / integration and deployment of new applications, systems software, and/or enhancements to existing applications throughout the enterprise.
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Develop overall strategy and architecture for areas of responsibility. Collaborate with other IT Managers to ensure cohesive enterprise architecture is achieved.
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Lead efforts to apply technology to solve complex business problems including understanding of company strategy to developing business requirements to successful implementation of solutions.
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Manage and provide direction for the team in support of business operations.
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Liaise with Infrastructure Services team for infrastructure needs.
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Review and analyze existing applications’ effectiveness and efficiency, and then develop strategies for improving or leveraging these systems proactively to improve business processes and decision-making capability.
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Research and make recommendations on software products and services in support of emerging and new business requirements.
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Ensure that any new software integration into company systems meets functional requirements, system compliance, and interface specifications.
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Cultivate, disseminate, and enforce functional policies, procedures, and quality assurance best practices.
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Responsible for oversight, management, development, implementation, and communication of department programs.
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Responsible for hiring, staff development, coaching, performance reviews, corrective actions, and termination of employees. Provide feedback, including regular one-on-ones and performance evaluations, for direct reports.
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Develop annual department budgets. Monitor spending versus the planned budgeted throughout the year and take corrective action where needed.
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Coordinate business activities by maintaining collaborative partnerships with key departments.
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Responsible for process improvement and working with other departments to improve interdepartmental processes. Utilize lean methodologies for continuous improvement. Utilize visual boards and daily huddles to monitor key performance indicators and identify improvement opportunities.
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Actively participate as a key team member in Manager/Supervisor meetings.
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Actively participate in various strategic and internal committees in order to disseminate information within the organization and represent company philosophy.
Supporting Responsibilities:
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Meet department and company performance and attendance expectations.
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Follow the Pacific Source privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
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Perform other duties as assigned.
SUCCESS PROFILE
Work Experience: Minimum of 5 years direct experience in software development and/or programming design and systems management in healthcare. Proven experience in overseeing the direction, development, and implementation of software solutions from business requirements to implemented solutions. Previous insurance industry with Epic healthcare software solutions required.
Education, Certificates, Licenses: Bachelor’s degree in computer science or similar field required or 10+ years equivalent work experience in lieu of degree. Certification in Epic Payer Platform preferred.
Knowledge: Strong knowledge of system and software quality assurance best practices and methodologies. Strong knowledge of Epic payer platform in utilization management and care management. Strong knowledge of pharmacy platforms and operations in a health care payer environment. Demonstrated ability to understand and contribute to business strategies, processes, and operations. Good project management skills and/or substantial exposure to project-based work structures, project lifecycle models, etc. Working knowledge of SQL, Power BI, database design and reporting. Knowledge of applicable data privacy practices and laws. Experience working in a team-oriented, collaborative environment. Strong customer-service orientation. Highly self-motivated and directed. Strong attention to detail.
Competencies
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Building Trust
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Building a Successful Team
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Aligning Performance for Success
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Building Partnerships
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Customer Focus
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Continuous Improvement
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Decision Making
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Facilitating Change
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Leveraging Diversity
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Driving for Results
Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 10% of the time.
Skills:
Our Values
We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business:
- We are committed to doing the right thing.
- We are one team working toward a common goal.
- We are each responsible for customer service.
- We practice open communication at all levels of the company to foster individual, team and company growth.
- We actively participate in efforts to improve our many communities-internally and externally.
- We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community.
- We encourage creativity, innovation, and the pursuit of excellence.
Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.
Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.
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