Revenue Management Specialist

15705 Indiana, Pennsylvania Wyndham Grand Clearwater Beach

Posted 12 days ago

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Wyndham Hotels & Resorts is now seeking a Revenue Management Specialist to join our team in Gurgaon, India.

Job Summary

The Revenue Management Specialists primary purpose is to serve participating hotels and assist the Team Lead Revenue Management Middle East & Eurasia by monitoring compliance with established Revenue Management Policies and Best Practices.

The specialist helps maximize room revenue and grow the RevPAR Index (market share) for each hotel in the portfolio. Key hotel team members include General Managers, Directors of Sales, Revenue Managers, and Front Office Managers, along with other stakeholders like Central Revenue Management Teams, management company reps, and Commercial Services Teams.

The role involves:

  • Building trust with hotel teams and revenue stakeholders
  • Developing and implementing appropriate Revenue Management strategies, including pricing
  • Aligning strategies and pricing with hotel teams and stakeholders

This is achieved through audits, analyzing, managing, and maintaining rates and rate codes in RMS, CRS, Lanyon, Property PMS, and connected channels.

Responsibilities
  • Conduct regular meetings (monthly, bi-weekly, weekly) with clients to review performance, opportunities, audits, and promotions.
  • Audit property setups to ensure content accuracy and proper distribution through systems.
  • Assist in rate and inventory adjustments, ensuring compliance with brand standards and policies.
  • Support complex properties in revenue management processes.
  • Guide rate loading, RFPs, and promotions, ensuring standards are met, and implement performance improvement plans.
  • Establish and maintain reports to understand each hotels market, goals, and challenges, ensuring inventory and rate visibility across channels.
Complexity
  • Decision-making is generally routine with some level of authority in specific cases.
  • Work involves standard tasks and procedures, with problem-solving involving standard options.
  • Participation in projects that may introduce new methods impacting hotel performance.
  • Regular interaction with property contacts and internal departments.

The role impacts revenue by ensuring adherence to standards and policies, increasing market share, revenues, customer loyalty, and brand awareness, while minimizing opportunity costs.

  • Clear communication skills, quick decision-making, stress management, multitasking, initiative, data analysis, presentation skills, interpersonal skills, financial understanding, and proficiency with MS Office and other systems are essential.
Experience/Certificates/Education
  • Bachelors Degree in Hospitality, Business, Finance, Economics, or at least two years of analytical experience in Revenue Management or Reservations.
  • Hospitality experience in EMEA markets.
  • Knowledge of office procedures and MS Office, familiarity with PMS, CRS, RMS, online channels, BI tools, and reporting.
  • Fluency in English.
Organizational Relationships

The Revenue Management Specialist reports to the Team Lead Revenue Management Middle East & Eurasia.

Company Overview:

Wyndham Hotels & Resorts is the worlds largest hotel franchising company with approximately 9,200 hotels across over 95 countries. Headquartered in Parsippany, NJ, with offices worldwide, Wyndham employs over 2,000 people dedicated to making hotel travel accessible for all. Our brands include Wyndham, La Quinta, Ramada, Days Inn, and Super 8. Our culture emphasizes integrity, accountability, inclusivity, caring, and fun.

Employment Disclaimer:

In some locations, Wyndham manages properties on behalf of third-party owners, acting as recruiter but not the employer.

What we expect from you

Be responsive, respectful, and deliver excellent experiences; foster inclusivity; bring your best every day.

What you can expect from us

Growth opportunities, competitive salary and benefits, wellness programs, and a diverse, inclusive culture.

About Wyndham

Wyndham champions the everyday traveler, offering the largest collection of hotel experiences worldwide, committed to making travel possible for all.

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Director Care Management

15065 Natrona Heights, Pennsylvania Highmark Health

Posted 4 days ago

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Job Description

**Company :**
Allegheny Health Network
**Job Description :**
**GENERAL OVERVIEW:**
Provides operational and strategic leadership for Hospital/facility Care Management Department. Collaborates with nursing and clinical leaders to assure smooth patient care progression and effective outcomes and care transitions. Directs collaborative efforts with physicians, revenue cycle and payor teams, and patients and their families to incorporate evidence based practices and appropriate use of resources. Communicates effectively with Hospital leadership in the development of day to day and strategic goals.
**ESSENTIAL RESPONSIBILITIES:**
+ Evaluates effectiveness,leads improvement efforts, and assesses outcomes within Hospital to assure appropriate access, care progression, transition, and level of care determination practices. (20%)
+ Studies and implements the care management model and structure to achieve sustainable length of stay, resource utilization, and clinical outcomes for patients over time.Responsible for designing and implementing improvement strategies for the care model on an ongoing basis. (20%)
+ Directs and oversees all activity related to referral management.Leverages Epic and Careport/Allscripts data to assess effectiveness.Collaborates closely with Highmark Home and Community Services to establishand/or enhance post-acute network. (15%)
+ Analyzes clinical service areas for operational effectiveness, using dashboards and other data sources.Monitors departmental performance against system initiatives and goals. (10%)
+ Assures that department works collaboratively with patients, families, peers, and other departments in the organization/network to meet established organizational goals for patient experience. (10%)
+ Pursues sharing of best practices through publication, presentation at conferences and networking with other AHN leaders throughout the system. (10%)
+ Establishes a development plan for the department, with a focus on effective use of resources, inter-professional collaboration, and coordination with chronic disease, transitional planning, and specialty teams. (5%)
+ Develops and implements workflows which assure efficient care coordination and transition, Hospital throughput, and adherenceto payer requirements in order to minimize financial risk to patients and the health system. (5%)
+ Lead and support evidence based projects & research by assisting in the identification of opportunities to incorporate the scientific method into practice. (5%)
+ Other duties as assigned.
**QUALIFICATIONS:**
Minimum
+ Bachelor's Degree in Nursing **OR** Master's Degree in Social Work
+ 5 years in Complex Transition Management
+ 1 year in a management or leadership capacity
+ Registered Nurse **OR** Licensed Social Worker
+ Strong communication and collaboration skills
+ Problem-solving
+ Resilient and agile change agent
+ Microsoft office suite
+ Act 34 Criminal Background Clearance Certificate.
+ Act 33 Child Abuse Clearance Certificate.
+ Act 73 FBI Fingerprinting Criminal Background Clearance Certificate.
Preferred
+ Master's Degree in Nursing, Health Administration, Leadership or related field
**_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._
**_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._
_As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._
_Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Req ID: J266566
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Sales Management Trainee

Valencia, Pennsylvania American Senior Benefits

Posted today

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Job Description

Job Description

At American Senior Benefits we are dedicated to serving those in need of insurance, especially seniors. We are proudly independent, answering only our customers. The choices our customers make are key life decisions and we work every day to help them find the right solutions at affordable prices. What we do is important, personal, and precise. Every time we help a customer decide what’s right for them, it makes them – and our organization – stronger. Offering a hybrid business model dash because a custom solution fits better, a vast product portfolio from best-in-class carriers and enjoying rapid growth and success in 175 nationwide locations we are ready to help America's seniors. Responsibilities

  • Conduct an initial interview to determine the needs of the client. Introduce and clearly explain all available insurance policy options to the clients.
  • Conduct field underwriting with utmost integrity.
  • Ensure that all medical and other necessary forms are filled out and submitted.
  • Arrange a payment method with the applicant.
  • Follow up on claims filed by clients.
  • Process all insurance policy requests.
  • Follow up with clients on scheduled basis for outstanding support.
  • Establish and support team members to hit agreed upon KPIS.
  • Become a subject matter expert in senior insurance solutions.
  • Follow approved guidelines, training, and support to recruit and train a team of insurance professionals.
  • Maintain a competitive, fun, inclusive environment.
Hear From Our Agents Qualifications
  • Competitive drive and winning mentality
  • Unparalleled work-ethic and grit
  • Strong communication skills
  • Ability to adapt and learn quickly.
  • Availability to start within a maximum of 6 weeks.
  • Previous leadership experience a plus.
*Compensation is highly customizable, and should be discussed directly with the onboarding manager.

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Sales Management Trainee

Valencia, Pennsylvania American Senior Benefits

Posted today

Job Viewed

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Job Description

Job Description

Job Description

At American Senior Benefits we are dedicated to serving those in need of insurance, especially seniors. We are proudly independent, answering only our customers. The choices our customers make are key life decisions and we work every day to help them find the right solutions at affordable prices. What we do is important, personal, and precise. Every time we help a customer decide what’s right for them, it makes them – and our organization – stronger. Offering a hybrid business model dash because a custom solution fits better, a vast product portfolio from best-in-class carriers and enjoying rapid growth and success in 175 nationwide locations we are ready to help America's seniors. Responsibilities

  • Conduct an initial interview to determine the needs of the client. Introduce and clearly explain all available insurance policy options to the clients.
  • Conduct field underwriting with utmost integrity.
  • Ensure that all medical and other necessary forms are filled out and submitted.
  • Arrange a payment method with the applicant.
  • Follow up on claims filed by clients.
  • Process all insurance policy requests.
  • Follow up with clients on scheduled basis for outstanding support.
  • Establish and support team members to hit agreed upon KPIS.
  • Become a subject matter expert in senior insurance solutions.
  • Follow approved guidelines, training, and support to recruit and train a team of insurance professionals.
  • Maintain a competitive, fun, inclusive environment.
Hear From Our Agents Qualifications
  • Competitive drive and winning mentality
  • Unparalleled work-ethic and grit
  • Strong communication skills
  • Ability to adapt and learn quickly.
  • Availability to start within a maximum of 6 weeks.
  • Previous leadership experience a plus.
*Compensation is highly customizable, and should be discussed directly with the onboarding manager.

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IT Financial Management Associate

19424 Oak Ridge, Pennsylvania PMA Companies

Posted 3 days ago

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Job Description

We are seeking a detail-oriented and proactive IT Invoicing & Procurement Analyst to manage day-to-day invoicing, procurement coordination, and data loading activities on our IT Financial Management (ITFM) platform. This role requires strong analytical and communication skills, and the ability to work closely with IT, finance, and vendor management teams to ensure accurate and timely financial operations.

Key Responsibilities:

  • Process, validate, and track IT-related invoices in accordance with company financial policies and budget controls
  • Coordinate with IT and procurement teams to support purchase requisitions, purchase order management, and contract alignment
  • Load, map, and reconcile financial and operational data in the ITFM platform (e.g., Nicus, ServiceNow ITBM, or similar)
  • Monitor invoice discrepancies, resolve exceptions, and follow up with vendors and internal stakeholders
  • Maintain accurate records and documentation of procurement and invoicing activities
  • Generate reports and summaries of IT spend, forecasts, and variances using Microsoft Excel and reporting tools
  • Collaborate with IT service owners, finance business partners, and vendors to ensure clear communication and alignment on billing and procurement expectations
  • Demonstrate commitment to Company's Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.
  • Associate or Undergraduate degree Secondary education focused on business, accounting, or finance.
  • Proficiency in Microsoft Excel, including:
  • Data formatting and cleansing
  • Use of LOOKUP functions (e.g., VLOOKUP, XLOOKUP, INDEX/MATCH)
  • PivotTables and basic reporting
  • Spreadsheet linking and data validation
  • Strong attention to detail and data accuracy
  • Communication & Interpersonal Skills
  • Excellent written communication skills for documenting processes, issue resolution, and reporting
  • Strong interpersonal and collaboration skills to work effectively with cross-functional teams including IT, finance, and vendors
  • Ability to interpret and communicate financial data to non-financial stakeholders clearly and concisely
  • Proactive in follow-ups and problem resolution
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Data Architect + Management AVP

19424 Oak Ridge, Pennsylvania Compunnel

Posted 1 day ago

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Job Description

Job Summary:

The Data Architect + Management (AVP) is responsible for defining and maintaining the enterprise data architecture framework, standards, and roadmaps aligned with property and casualty (P&C) insurance business needs.

This role leads the adoption of Microsoft Fabric as the enterprise data platform and ensures best practices in data modeling, integration, governance, and analytics enablement.

The AVP partners with business and IT stakeholders to support key functions such as underwriting, claims, policy administration, regulatory reporting, and actuarial analysis.



Key Responsibilities:
  • Define and maintain enterprise data architecture standards and roadmaps.
  • Lead the adoption and optimization of Microsoft Fabric as the enterprise data platform.
  • Drive best practices in data modeling, integration, storage, security, governance, and analytics.
  • Align data strategy with core insurance functions including underwriting, claims, and regulatory reporting.
  • Manage end-to-end delivery of data programs and projects, ensuring timely and value-driven outcomes.
  • Provide hands-on technical leadership including architecture reviews, solution design, and troubleshooting.
  • Collaborate with cross-functional teams to deploy scalable data pipelines and analytics platforms.
  • Ensure compliance with data security and privacy regulations (e.g., GDPR, HIPAA, state/federal insurance laws).
  • Build and mentor a high-performing team of data engineers, architects, and analysts.
  • Act as a trusted advisor to executive leadership on data strategy and emerging technologies.
  • Foster a culture of innovation, continuous improvement, and delivery excellence.
Required Qualifications:
  • Bachelor’s degree in Computer Science, Data Management, Engineering, or related field (Master’s preferred).
  • 12+ years of IT/data management experience.
  • 5+ years in data architecture leadership roles.
  • Proven experience in P&C insurance data domains (policy, claims, billing, underwriting, actuarial).
  • Strong experience implementing and managing Microsoft Fabric (OneLake, Synapse, Data Factory, Power BI, Real-Time Analytics, Governance).
  • Successful track record in data modernization, cloud migration, or analytics transformation programs.
  • Expertise in data modeling, data warehousing, ETL/ELT, and modern data lake architectures.
  • Strong knowledge of the Azure ecosystem (Azure SQL, Data Factory, Synapse, Purview, Power BI).
  • Hands-on experience with SQL, Python, and/or Spark.
  • Familiarity with API-driven integrations, master data management, and metadata frameworks.
  • Strong project/program management capabilities.
  • Excellent communication and stakeholder engagement skills.
  • Ability to balance strategic oversight with hands-on technical delivery.


Education: Bachelors Degree
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Team Leader - Asset Management

15705 Indiana, Pennsylvania Computacenter AG & Co. oHG

Posted 7 days ago

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Location: IN - Bangalore 24/7 | Job-ID: 210358 | Contract type: Standard | Business Unit: Others

Life on the team

A Technical Contract Management Team Leader in FLSs shared service organization with ServiceNow Asset Management is responsible for overseeing the management of contracts and ensuring the efficient use of assets within the ServiceNow platform. Youll get to work with some of the most talented and passionate people in the business and get exposure to leading edge technologies which will enable you to advance your skills.

What youll do
  • Operate during European hours primarily with exceptions for India hours
  • Lead and manage a team of asset/contract management professionals
  • Responsible for understanding operational requirements, researching best practices, and maintain highest level of performance of the team
  • Ensure all assets/contracts are properly managed, tracked, and renewed as necessary.
  • Oversee the use and management of assets within the ServiceNow platform.
  • Identify and implement improvements to contract and asset management processes.
  • Maintain effective communication with stakeholders, including clients and senior management.
  • Ensure compliance with relevant regulations and internal policies.
  • Prepare and present regular reports on contract and asset management activities.
  • Responsible for training and development opportunities for team members
  • Demonstrates Computacenter winning together values for the position level.
  • Responsible for management of resourcing requirements
  • Responsible to cultivate a team environment that provides exceptional interactions and ensuring all staff members perform at a consistently high level.
  • Attending and responding to written / electronic correspondence and liaise closely with onshore Functional teams for day-to-day operations.
  • Act on team members feedback and resolve any issues or conflicts within the team.
  • Responsible for applying matrix organization guidelines
What youll need
  • Proven experience in contract management and asset management, preferably within the ServiceNow platform with 7 to 12 years of experience.
  • Strong leadership and team management abilities.
  • Willingness to adapt quickly to new working conditions and deliver outcomes
  • Curiosity to understand systems, processes and people for delivering outcomes
  • Proficiency in ServiceNow and other relevant software tools.
  • Excellent analytical and problem-solving skills.
  • Prior experience working in a matrix organization
  • Strong verbal and written communication skills.
  • A degree in business, finance, or a related field is often preferred.
About us

With over 20,000 employees across the globe, we work at the heart of digitisation, advising organisations on IT strategy, implementing the most appropriate technology, and helping our customers to source, transform and manage their technology infrastructure in over 70 countries. We deliver digital technology to some of the worlds greatest organisations, driving digital transformation, and enabling people and their businesses.

Learning and development

Our people are our strength which is why we offer leadership training, coaching, mentoring, professional development, and international opportunities. Whichever direction you choose to go in whether its a well-trodden path or a completely new part of the business well support you. Our managers champion their people, powering their personal development and helping them to reach their full potential.

We passionately believe in the power of diversity and inclusion. We celebrate our differences because we know a diverse workforce with different experiences and perspectives helps us win together. And to do that, you need to feel comfortable to bring your whole self to work and you can only do that when you feel supported, valued, and have a sense of belonging which is what we strive to achieve.

Your application is considered on its merits regardless of your age, disability, ethnicity, faith, gender identity or sexual orientation. All that matters to us is that you share our vision and our values, and that you bring the experience and skills we need.

We are proud to be a Disability Confident Employer, we welcome applications from people with a disability and guarantee to interview applicants who have a disability and meet the essential requirements for the job.

About us

Computacenter is a leading independent provider of IT infrastructure services, with about 20,000 employees worldwide. We work at the heart of digitisation, advising organisations on IT strategy, implementing the most appropriate technology and managing our customers infrastructures.

We offer a friendly, open working environment without too much fuss about hierarchy. We are looking for professionals with diverse competencies, personalities and strengths who want to live our shared value of teamwork and performance.

Interested in joining a company with a strong sense of community?

Were growing. Were hiring. We encourage. We empower. We support.
#winningtogether #peoplematter

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About the latest Management positions Jobs in Kittanning !

Product Management Analyst I

15024 Cheswick, Pennsylvania Hire Talent

Posted 4 days ago

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Job Title: Product Data Sheet Specialist (Contract)
Location: Cheswick, PA 15024
Contract Duration: (6 months, with possibility of extension)
Department: Product Management / Marketing / Technical Documentation
Reports To: Commercial Operations Director (Temporarily)

Job Summary:
We are seeking a detail-oriented and dedicated Product Data Sheet Specialist on a contract basis to support the creation, maintenance, and accuracy of our Protective Coatings and Marine product data sheets. The specialist will work closely with cross-functional teams to ensure product information is current, consistent, and compliant with company and industry standards, enabling effective sales, marketing, and customer support.

Key Responsibilities:
• Assist in developing, updating, and maintaining product data sheets for various product lines.
• Collaborate with product managers, field technical services, R&D, marketing, and sales teams to collect and verify accurate product information.
• Ensure product data sheets adhere to company standards and regulatory requirements.
• Maintain version control and organize document management systems to ensure data sheet accuracy.
• Perform regular reviews and audits of product data sheets to identify and correct errors or outdated information.
• Coordinate with external vendors or partners as needed to obtain or confirm product specifications.
• Support the preparation of technical documentation and marketing materials related to product data.
• Provide assistance to internal teams in accessing and utilizing product data sheets effectively.
• Suggest improvements to data sheet management processes and tools.

Qualifications:
• Bachelor's degree in Business, Marketing, Engineering, Technical Writing, or a related field preferred.
• Experience in product data management, technical documentation, or a similar role.
• Strong attention to detail and excellent organizational skills.
• Proficiency with document management systems and Microsoft Office Suite; familiarity with product information management (PIM) software is a plus.
• Good communication skills and ability to collaborate with multiple departments.
• Ability to manage multiple tasks and meet deadlines.
• Knowledge of industry standards and regulatory requirements related to product documentation is beneficial.

Preferred Skills:
• Experience in paint and coatings industry
• Product knowledge: Deep understanding of product specifications, applications, and industry standards.
• Technical Writing: Ability to create clear, concise, and accurate documentation tailored to various audiences
• Regulatory Compliance: Familiarity with industry regulations (e.g., REACH, RoHS, GHS) and documentation standards.
• Data Management: Proficiency in managing large datasets, often using tools like Excel, SAP, or PLM systems.
• Basic knowledge of graphic design tools for formatting data sheets (e.g., Adobe InDesign) is a plus.
• Attention to detail: Critical for ensuring accuracy in technical content and formatting.
• Analytical and problem-solving skills.
• Communication: Strong written and verbal communication to collaborate with cross-functional teams and convey complex information clearly.
• Project management: Managing timelines and deliverables for multiple product updates or launches.
• Adaptability: Comfort with evolving product lines, regulatory changes, and shifting priorities.
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Senior Manager, Project Management - Imaging

19424 Oak Ridge, Pennsylvania ICON Clinical Research

Posted 4 days ago

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Senior Manager, Project Management - Imaging - Remote, US
ICON plc is a world-leading healthcare intelligence and clinical research organization. We're proud to foster an inclusive environment driving innovation and excellence, and we welcome you to join us on our mission to shape the future of clinical development.
**Overview**
Responsible for the overall tactical and strategic direction and management of projects through designated project managers, ensuring consistency with corporate strategy, consistency of process across projects and internal and external customer satisfaction with the projects. Directs and provides day-to-day tactical oversight to their assigned Project Management team. Provides vision, leadership and mentorship to assigned team with respect to performance and career development. Accountable for the overall direction, coordination, implementation, execution, control and completion of all programs/projects, ensuring consistency with company strategy, commitments and goals. Accountable for compliance of the Project Management team with IMC and ICON policies and procedures. Ensure optimal planning, allocation and performance of resources within Project Management.
**Essential** **Duties/Responsibilities**
+ Recognize, exemplify and adhere to ICON's values which center around our commitment to People, Clients and Performance.
+ Recognize the importance of and create a culture of process improvement with a focus on streamlining our processes adding value to our business and meeting client needs.
+ Maintaining a positive, results-oriented work environment by building partnerships, modeling teamwork and communicating in an open, balanced and objective manner
+ Providing strategic and tactical management to assigned team of Project Managers and Project Assistants
+ Mentoring and managing assigned project management team through establishment of mutually agreed objectives and professional development plans, and by monitoring successful achievement and performance
+ Build and maintain the performance and effectiveness of assigned project management team, including regular checks on team health and identification and resolution (including escalation to the appropriate level) of team performance issues.
+ Ensuring adequate training is provided to employees for all new and updated processes
+ Assessing Training Curriculum and current staff understanding and identify training needs, for new employees and for continuous improvement/development of existing staff
+ Managing project workload and resource forecasts for the group, as well as project assignments
+ Identifying personnel resources for new and existing projects
+ Developing operational metrics for assessment of project performance
+ Serving as the escalation point for project managers in resolution of customer or cross-functional issues that cannot be resolved at the project manager level
+ Ensuring the proper tools are provided to the team and that they are being used effectively; identify/obstacles and make corrective actions/recommendations as necessary
+ Monitoring the efficiencies of current operational processes and identify and/or lead opportunities for improvement
+ Providing senior management with team performance metrics as assigned
+ Lead or participate in strategic planning and risk assessment, by managing the development and delivery of appropriate contingency activities in the context of the budget, time, resources and value targets and in accordance with SOPs. Communicating Best Practice/Lessons Learned Feedback
+ Analyze department and project financial data, identify issues/trends and implement corrective action plans as necessary to ensure profitability.
+ Promoting a proactive, professional culture within the Project Management department and contributing to the group's success
+ Ensuring the team is compliant with standard procedures and other company policies
+ Leading customer meetings and escalations when required
+ Support staff recruitment, including interviews and supporting hiring process.
+ Other responsibilities as assigned by senior management
+ Travel required up to 25% of the time
**Your Profile:**
+ Minimum of a Bachelor's Degree in life sciences, project management, business administration, or a related field; advanced degree or relevant certifications (e.g., PMP) are preferred.
+ Proven leadership experience from an Imaging CRO. Imaging CRO experience is a non-negotiable requirement.
+ Extensive experience in project management within the clinical research or pharmaceutical industries.
+ Supervisory experience required
+ Strong leadership and organizational skills, with a proven ability to manage multiple projects and priorities effectively.
+ Excellent analytical and problem-solving skills, with a focus on data-driven decision-making.
+ Strong communication and interpersonal skills, capable of engaging and influencing stakeholders at all levels.
**What ICON can offer you:**
Our success depends on the quality of our people. That's why we've made it a priority to build a diverse culture that rewards high performance and nurtures talent.
In addition to your competitive salary, ICON offers a range of additional benefits. Our benefits are designed to be competitive within each country and are focused on well-being and work life balance opportunities for you and your family.
Our benefits examples include:
+ Various annual leave entitlements
+ A range of health insurance offerings to suit you and your family's needs.
+ Competitive retirement planning offerings to maximize savings and plan with confidence for the years ahead.
+ Global Employee Assistance Programme, LifeWorks, offering 24-hour access to a global network of over 80,000 independent specialized professionals who are there to support you and your family's well-being.
+ Life assurance
+ Flexible country-specific optional benefits, including childcare vouchers, bike purchase schemes, discounted gym memberships, subsidized travel passes, health assessments, among others.
Visit our careers site ( to read more about the benefits ICON offers.
At ICON, inclusion & belonging are fundamental to our culture and values. We're dedicated to providing an inclusive and accessible environment for all candidates. ICON is committed to providing a workplace free of discrimination and harassment. All qualified applicants will receive equal consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
If, because of a medical condition or disability, you need a reasonable accommodation for any part of the application process, or in order to perform the essential functions of a position, please let us know or submit a request here ( in the role, but unsure if you meet all of the requirements? We would encourage you to apply regardless - there's every chance you're exactly what we're looking for here at ICON whether it is for this or other roles.
Are you a current ICON Employee? Please click here ( to apply
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VP Risk Adjustment Accuracy Management

19424 Oak Ridge, Pennsylvania Highmark Health

Posted 4 days ago

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Job Description

**Company :**
Highmark Inc.
**Job Description :**
**GENERAL OVERVIEW:**
This position is responsible for risk revenue management for all government program products (commercial ACA, Medicare, and Medicaid). Establishes the strategic direction for the Risk Revenue Management process, assessment of revenue and cost trends to achieve revenue targets and improve quality of care for our members. Drives the coordination with multiple stakeholders to implement and execute on the strategic direction and optimize our revenue management capabilities. Builds strong analytical functions to focus resources on providing optimal financial returns in a fully compliant manner. Develop a Risk Management governance strategy for the Enterprise to appropriately manage CMS audit risk.
**ESSENTIAL RESPONSIBILITIES:**
1. Program Development and Management:
+ Provide strategic leadership and management for the Risk Adjustment Accuracy Management Department.
+ Develop and oversee programs to ensure comprehensive and accurate diagnosis coding for risk adjusted government programs (Medicare Advantage, ACA business, and Medicaid). Also work with Care Management to ensure that this information is used to improve the management of a member's care.
+ Collaborate with key internal stakeholders (Clinical Services, Provider Transformation, Network Contracting, Actuarial, Finance and Compliance) to develop, implement, and continually refine prospective and retrospective diagnosis coding programs and provider support.
+ Oversee execution of all coding programs and processes, both vendor supplied and internal.
+ Monitor and analyze the effectiveness of programs, processes, infrastructure, and reporting, and make changes to improve results and effectiveness.
+ Identify, evaluate and implement new programs or modifications to existing coding programs and develop strategies to implement.
+ Develop, oversee and adapt infrastructure (processes, systems, talent) to support an effective risk adjustment program as CMS/HHS/DPW evolves the models and guidance.
+ Accountable for achieving financial targets related to risk adjustment activities and complying with all government and commercial regulations. Build financial dashboards and benchmarks for each program individually as well as all revenue programs in aggregate.
+ Manage a budget of approximately $70M.
2. Quality Assurance/ Compliance
+ Implement a governance structure that provides significant oversight of the governmental audit and compliance risks.
+ Build statistically sound strategies to evaluate and educate senior management of the risk and rewards involved in key risk revenue strategies.
+ Collaborate with the Government Program Compliance Officer to develop, execute and continually refine a quality assurance program to monitor, audit and improve the quality of provider medical record documentation, and diagnosis coding.
+ Develop and enhance infrastructure and reporting to support QA programs
+ Develop and implement remediation strategies as needed with individual providers, provider groups and the network as a whole
3. Analytics
+ Lead a team that develops and oversees analysis of risk adjustment programs including ROI, productivity, quality, risk score/ revenue impact at the plan and provider group level.
+ Lead a team that develops and supports analytics related to government quality programs such as Medicare STARS and the ACA Quality Rating System.
+ Utilize analytics to identify trends and opportunities for improvement, new strategies and further program development
+ Collaborate with Actuarial to project and monitor the impact of coding programs on revenue for forecasting and monthly financial statement accruals.
+ Develop capabilities to identify both opportunities and weaknesses in the government's actuarial risk score models to inform better business decisions
4. Operations and Data Submission
+ Manage an operations team responsible for submitting accurate and comprehensive data to the government.
+ Oversee both the CMS RAPS/Encounter data submissions as well as Edge Server submission for the ACA products.
+ Develop, implement and oversee controls and reporting to ensure effective processes are in place throughout the organization
+ Develop and oversee processes and reporting that ensure complete and timely correction and resubmission of data errors from CMS
5. Vendor Management
+ Manage relationship and contracting strategy for multi-million dollar vendor contracts.
+ Collaborate with Procurement to negotiate and execute vendor contracts with strong compliance and financial protections.
6. People Development
+ Be a strong and effective leader focused on staff development and growth
+ Communicate effectively and confidently with all levels of the organization
7. Other duties as assigned or requested.
**QUALIFICATIONS:**
Minimum:
+ Bachelor's degree
+ Ten or more years' work experience in health care with emphasis on analysis and process optimization
+ At least five years' direct management experience
Preferred:
+ 5 or more years' Medicare and/or Commercial risk adjustment experience
+ Previous involvement with complex and unique issues and proficiency in the healthcare industry
+ Credentialed Actuary (FSA/ASA) or Advanced Degree (MBA)
Language (Other than English):
None
Travel Requirement:
0% - 25%
**PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS**
Position Type
Office-based
Teaches / trains others regularly
Occasionally
Travel regularly from the office to various work sites or from site-to-site
Rarely
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
Yes
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Occasionally
Lifting: 25 to 50 pounds
Rarely
**_Disclaimer_** _: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._
**_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._
_As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._
_Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Req ID: J263206
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