Technical Project Manager in the greater Baltimore, MD
*Title:* Technical Project Manager
*Location:* Owings Mills, MD
*Duration: *12 months
Gc or USC or EAD GC
*Interview: *Phone, then In-Person *(local candidates required)*
*Project Description & Purpose of Position*
- With the Affordable Care Act, customers at a certain income level are
qualified to receive a government subsidy. This subsidies are then to be
paid by the government to the insurers (CareFirst) for each qualifying
member.
- Prior to 2016, from CareFirst accounting systems, CareFirst would
invoice CMS or the Federal Government for subsidies.
- Based on a new January 2016 mandate, CMS or the Federal Government,
will initiate the subsidy payments, based on their records, not CareFirst’s.
- This has opened up a series of process changes. Such as, financial
reconcilements each month, identify discrepancies, and work out a means to
agree on a certain amount of money they are due to be paid, factoring in
retroactivity from previous monthly errors.
- Must build a system to understand where the discrepancies are found.
Internal Corporate initiative that has been funded, where a technical
project team is working with this business area.
- Requires a technical project manager who will come in, represent the
business in this endeavor, to help turn this process around, and put the
right infrastructure in place.
- The business understands the functional aspect, but lacks a technical
aspect to serve as their advocate.
- This project is starting with the federal exchange, specifically
Virginia. By January 2018, CareFirst must be up and running for DC and
Maryland
- Work with the technical teams, including the Technical Delivery
Manager, business areas, mandates, and audit teams.
*Responsibilities*
- Managing cross functional business and technical teams through
multiple work streams to deliver enhancements to CareFirst and business
partner systems as required by the Affordable Care Act
- Act as a change catalyst with expert relationship management skills
that successfully establish credibility with all levels of organization to
influence and achieve desired results
- Guide meetings with cross-functional teams
- Lead process re-engineering related to the new mandates
- Establish a short-term and long-term structure that adheres to the new
2016 mandates.
- Represent the business in technical meetings, serving as their
advocate.
- Strong healthcare insurance background
*Required Skills*
- Thorough understanding of State & Federal exchange file integration,
Automated Enrollment process, and financial reconciliation.
- Strong knowledge of enrollment and payment activity is a must
- Strong knowledge of the Affordable Care Act
- Extensive project management experience with the ability to manage
cross-functional teams
- Strong technical background
- Strong project management background related to financials,
understanding of reconciliation
- Strong process writing/workflow creation experience
*Preferred Skills*
- Facets platform experience
*About the Team*
- Led by the Senior Director, Operations Individual Market, Enrollment,
Billing and Collections. His LinkedIn summary is below:
- I am accountable for the enrollment, billing and collections
processes and operations for all individual business at CareFirst (ACA
Public, Private, Under 65, Medigap, and Medicare Part D). This includes
ensuring that the enrollment and billing operations are executed
in a high
quality, repeatable, and efficient manner. I provide leadership to
reengineer and implement new processes and systems to move the
organization
towards highly automated billing processes with the majority of
transactions being done by our members via self-service. I also
design the
enrollment and billing operations to ensure the highest level of customer
satisfaction and retention. In this role I’m held accountable for
proactively changing the system and processes in accordance with Federal
Health Care Reform. This will include designing and implementing any
enrollment, billing and/or collection related tools required for Health
Insurance Exchanges and Federal Subsidy programs for qualified
individuals.
- I also assumed oversight of operational functions, including
Service and Enrollment, to service the Maryland Health Insurance Plan
(MHIP) account with optimum efficiency, quality, timeliness and
accuracy to
achieve all internal and external corporate goals and objectives, while
providing support to all internal areas as needed. In this capacity, I
serve as the relationship manager with senior executive management both
internally and externally, including the CEO, SVP, Healthcare Analytics,
and key regulatory and legislative personnel.
- Direct responsibility for 200,000+ subscribers with a direct budget
of $4M with approximately 50 employees and indirect control of
$43M budget
with 100+ indirect employees.
- Responsible for getting applications in from various federal and state
based exchanges for the Affordable Care Act.
- Getting invoices out the door, collecting payments and reconcilements.
*Warm Regards,*
*Randhir Kumar*
*IDC Technologies*
*1851 McCarthy Blvd. Suite 116, Milpitas, CA 95035*
*Email: **randhir.ku...@idctechnologies.com
<randhir.ku...@idctechnologies.com>*
*Phone: *
*408-459-1535 Web: www.idctechnologies.com
<http://www.idctechnologies.com/> *
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