Providence Health & Services Medicare Benefit Manager in Washington
Providence St. Joseph Health is calling Medicare Benefit Manager based out of our location in Beaverton, OR. The role can be based in the footprint of Providence in the states of AK, OR, WA, MT, TX, CA, and NM. The role will be remote and could require in office work in the future.
We are seeking a Medicare Benefit Manager who will be accountable for and facilitates Providence Health Plan's detailed benefits management supporting the Medicare line of business. The Medicare Benefits Manager is responsible to support detailed benefits requirements and deliverables for the full life cycle of the Medicare product portfolio: including benefit scenario analysis, operational impact analysis, business decision documentation development, supporting the annual materials process and Medicare product life-cycle deliverables by phase. The Medicare Benefits Manager will be responsible for a highly detailed understanding and expertise of PHP Medicare benefits across the portfolio, providing support and thought-partnership to all stakeholders and team members supporting the successful annual life-cycle and delivery of the Medicare portfolio.
This role must maintain effective and efficient working relationships with relevant teams and functions, including the Medicare Product and Marketing, Sales, Finance, Compliance and operational teams.
Prioritization of work in a high-demand role and adjusting to changes throughout the Medicare product annual life-cycle.
Competing priorities and resources demands in a role that is highly dependent on various internal teams and capabilities including external vendors and regulatory bodies to accomplish annual and day-to-day work activities.
Staying current on industry news & developments and anticipating potential impacts to benefit design and/or administration in a fast paced, ever changing environment.
Handling tough questions with confidence and without intimidation.
Using good judgment skills in knowing when and how to best escalate issues that may be impeding forward movement.
Gaining enthusiastic collaboration and trust when introducing change to existing processes while working in a matrix team environment.
Working towards potential enhancements or refinements within an existing organizational culture.
Patient Population Served: Not Applicable
In this position you will have the following responsibilities:
Detailed scenario analysis for Medicare portfolio planning including benefits that cross lines of business.
Detailed understanding of Product, Membership, Claims, Pricing, billing, etc. configuration and workflow.
Detailed benefit categorization and alignment for bid submission.
Support MPD audit and review.
Detailed benefit support for material development, review and publication.
Manage annual benefit change control process.
Support benefits management in relation to regulatory mandates, competitive environments, risk management, price impact, medical policy and operational feasibility.
Support training process and materials creation regarding Medicare benefits.
Develop business decision documentation and tracking process related to benefits administration.
Maintain functional working relationships with vendors to complete deliverables for the Medicare product annual life-cycle.
Required qualifications for this position include:
Bachelor's Degree in Business or Healthcare Administration - OR - 5 years of relevant (CMS) Medicare work experience.
Proven experience working with teams and staff of various capacities, approach and work-styles.
Proven oral presentation experience.
Experience working in an environment with shifting priorities requiring flexibility and the ability to prioritize work.
Experience supporting scenario and impact analysis in support of annual strategic benefit planning and change impact.
5 years experience working with benefits in a fast-paced Medicare product annual life-cycle capacity.
Both broad and deep experience with current Medicare benefits, product portfolio and annual life-cycle process.
Preferred qualifications for this position include:
- Experience working with Facets.
About Providence in Oregon.
As the largest healthcare system and largest private employer in Oregon, Providence offers exceptional work environments and unparalleled career opportunities.
The Providence Experience begins each time our patients or their families have an encounter with a Providence team member and continues throughout their visit or stay. Whether you provide direct or indirect patient care, we want our patients to feel that they are in a welcoming place where they can be comfortable and free from anxiety. Our employees create the Providence Experience through simple, caring behaviors such as acknowledging and welcoming each visitor, introducing ourselves and Providence, addressing people by name, providing the duration of estimated wait times and updating frequently if timelines change, explaining situations in a way that puts patients at ease, carefully listening to their concerns, and always thanking people for trusting Providence for their healthcare needs. At Providence, our quality vision is simple, "Providence will provide the best care and service to every person, every time."
Providence is consistently ranked among the top 100 companies to work for in Oregon. It is also home to two of our award-winning Magnet medical centers. Providence hospitals and clinics are located in numerous areas, ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland. If you want a vibrant lifestyle while working with a team highly committed to the art of healing, choose from our many options in Oregon.
We offer comprehensive, best-in-class benefits to our caregivers. For more information, visit
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Non-Clinical Lead/Supervisor/Manager
Other Location(s): Montana, California, Washington, New Mexico, Oregon, Alaska
Req ID: 315759