Manager of Technical and Analytical Operations

Medical Associates Health Plans is hiring a Manager of Technical and Analytical Operations to join our team!

Where You Will Be Working: 

Medical Associates Clinic and Health Plans is a multi-specialty group practice combined with a growing health insurance company.  Our 1,100 healthcare and health insurance professionals lead the way in providing quality healthcare and top-notch insurance products in Northeast Iowa, Southwest Wisconsin, and Northwest Illinois. This position is an onsite position, based out of the finance department located at the Medical Associates Health Plans in Dubuque, Iowa.

Benefits Package Includes: 

• Single or Family Health Insurance with discounted premium rates for wellness program participation.
• 401k with immediate matching (50% on the dollar up to 7% of pay) + additional annual Profit Sharing
• Flexible Paid Time Off Program (24 days off/year)
• Medical and Dependent Care Flex Spending Accounts
• Life insurance, Long Term Disability Coverage, Short Term Disability Coverage, Dental Insurance, etc.

Major Responsibilities:

• Develop, oversee and verify reporting for the Health Plan and Clinic.  Create and manage related ad hoc reports/reporting including internal auditing and operational performances.  Oversee the analysis of actual claim results versus medical budgets for Health Plan and investigate variances.  Consult with health services on results and corrective action possible or necessary.
• Manage MAHP Programmers, project list and incidents in an efficient and timely manner.  Determine best tool sets for project roll out and implement automation where possible for reoccurring reporting needs.
• Perform actuarial analysis for premium and pricing calculations. Utilize established medical underwriting practices as guidelines for risk evaluation of small group pools and large group proposals.  Based on these guidelines, review risk and rate calculations of all prospective rate proposals and renewals on a regular basis and make recommendations to the underwriting review team. Provide analytical/actuarial support in evaluation of rating factors, product development, and financial/medical budgets.  Coordinate premium rating and regulatory filings.  Monitor ongoing federal regulations as related to rating.
• Interface with vendors as needed and ensure ongoing system and operational day-to-day functions. Collaborate in short and long range planning with the broader IT Department to ensure proactive, forward-thinking strategies are in place and the team is working collaboratively in support of these strategies and objectives.  Partner with IT Director to foster a connected work group with the health plan and clinic programmers.
• Preparation of the quarterly reports and budget projections for the Medicare cost report. Preparation of all workpapers for the annual cost report, along with the coordination of the auditors preparing the annual cost report.
• Manage selection, training, development, performance evaluation, and performance issues for direct reports.  Prepare schedule and assign work to assure adequate staffing levels to deliver a high level of customer service.
• Complete all other duties as assigned.

Knowledge and Skills:

Experience                   Five years to ten years of similar or related experience. 

Education                    Equivalent to a college degree. 

Interpersonal Skills       The ability to motivate or influence others is a material part of the job, requiring a significant level of diplomacy and trust.  Obtaining cooperation (internally and/or externally) is an important part of the job. 

Other Skills                Advanced skills in Microsoft products, experience with analytics and data mining.

Physical Aspects:

Reaching - Extending hand(s) and arm(s) in any direction.

Lifting - Raising objects from a lower to a higher position or moving objects horizontally from position-to-position. This factor is important if it occurs to a considerable degree and requires the substantial use of the upper extremities and back muscles.

Fingering - Picking, pinching, typing or otherwise working, primarily with fingers rather than with the whole hand or arm as in handling.

Grasping - Applying pressure to an object with the fingers and palm.

Talking - Expressing or exchanging ideas by means of the spoken word. Those activities in which they must convey detailed or important spoken instructions to other workers accurately, loudly or quickly.

Hearing - Perceiving the nature of sound with or without correction. Ability to receive detailed information through oral communication and to make fine discriminations in sound, such as when making fine adjustments on machined parts.

Vision - 20 / 40 or better in the best eye with or without correction.

Repetitive Motions - Substantial movements (motions) of the wrists, hands and/or fingers.

Sedentary Work - Exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

Environmental Conditions:
None - The worker is not substantially exposed to adverse environmental conditions (such as in typical office or administrative work).

Medical Associates Clinic & Health Plans is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, pregnancy, age, national origin, marital status, parental status, disability, veteran status, or other distinguishing characteristics of diversity and inclusion, or any other protected status. Please view Equal Employment Opportunity Posters provided by OFCCP https://www.eeoc.gov/poster