Supervisor Medical Economic System at Blue Cross Blue Shield Kansas in Topeka, Kansas

Job Description:

The Supervisor Medical Economics Systems supervises a team that manages the identification, research, testing, coordination, support, approval, and documentation of system development and modifications for the medical economics department. This role acts as a liaison between the medical economics department, Information Services (IS), various business areas across the company, and the provider directories vendor. This role ensures the effective implementation and operation of provider systems.


"This position is eligible to work hybrid (9 or more days a month onsite) in accordance with our Telecommuting Policy. Applicants must reside in Kansas or Missouri or be willing to relocate as a condition of employment."



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Why Join Us?

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  Family Comes First: Total rewards package that promotes the idea of family first for all employees; including paid time off and family first leave.


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  Professional Growth Opportunities: Advance your career with ongoing training and development programs both through our internal Blue University and external opportunities.


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  Trust: Work for one of the most trusted companies in Kansas.


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  Inclusive Work Environment: We pride ourselves on fostering a diverse and inclusive workplace where everyone is valued and respected.


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  Lead and Inspire: Guide and mentor your team to achieve their full potential and success.

• Blue Cross and Blue Shield of Kansas offers excellent competitive compensation with the goal of retaining and growing talented team members. The compensation range for this role is a good faith estimate, it is estimated based on what a successful candidate might be paid. All offers presented to candidates are carefully reviewed to ensure fair, equitable pay by offering competitive wages that align with the individual's skills, education, experience, and training. The range may vary above or below the stated amounts.

• Lead and supervise a team responsible for the communication between Information Services (IS) and corporate users regarding medical economics related system development, problems, and modifications.


• Oversee the maintenance of medical economics systems and ensure systematic knowledge transfer and training within the team.


• Manage major provider directory modifications and coordinate communications with external vendors. Supervise the testing of system problems and new system modifications to ensure efficiency and accuracy.


• Develop and oversee the implementation of test scenarios for each system update to ensure comprehensive coverage.


• Direct departmental communication regarding system problems, modifications, and upgrades to ensure alignment across the organization.


• Ensure accurate documentation of system problems, modifications, and solutions, maintaining high communication standards with medical economics management and IS.


• Formulate and update departmental policies and administrative procedures to optimize system functionality and user interaction.


• Mentor and support team members in providing research, instruction, and assistance to all system users.

• High school graduate or equivalent required; Bachelor's degree in Computer Science, Business Administration, Economics, Accounting, or similar preferred.


• Experience in setting up and conducting system tests required.


• Two years of experience in provider relations or medical economics is strongly preferred.


• Exposure to provider claim coding data and systems testing preferred.


• Thorough understanding of system testing principles, including setting up test cases and verifying test results.


• Proficient in SQL preferred and ability to use system commonly used for Membership, Claims, TSO, QMF, and provider directories.


• Strong analytical and problem-solving skills with the ability to present facts logically.


• Excellent communication skills, capable of effective training and system assistance.


• Knowledge of HIPAA regulations and provider claim coding data (ICD, MS-DRG's, CPT, HCPCS).


• Ability to work independently and manage multiple projects with critical deadlines.


• Familiarity with Agile software development and project management methodologies.


• High degree of accuracy and attention to detail required in all work.

• Base pay is only one component of your competitive Total Rewards package:
  
  
  
  • Incentive pay program (EPIP)
  
  
  • Health/Vision/Dental insurance
  
  
  • 6 weeks paid parental leave for new mothers and fathers
  
  
  • Fertility/Adoption assistance
  
  
  • 2 weeks paid caregiver leave
  
  
  • 5% 401(k) plan matching
  
  
  • Tuition reimbursement
  
  
  • Health & fitness benefits, discounts and resources