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Manager, DataRAP Application Development - WellMed - San Antonio, TX

UnitedHealth Group


Location:
San Antonio, TX
Date:
06/23/2017
2017-06-232017-07-22
Job Code:
1742148
Apply on the Company Site
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Job Details


Manager, DataRAP Application Development - WellMed - San Antonio, TX(Job Number:711919)
Description

Supervises, directs, plans, and organizes the DataRAP Application Development team to ensure that all DataRAP applications related functions necessary to perform daily operational processes for WellMed, and Local Care Delivery Organizations (LCDO), occur timely and efficiently. This position is also responsible for ensuring timeliness and completeness as well as accuracy of the risk adjustment data submitted to payors on behalf of WellMed. Prioritizes establishment of an effective submission/reconciliation process that is implemented and monitored for risk adjustment, quality, and encounter data that meets compliance and regulatory requirements. Works with the senior leadership to establish and maintain an accountable deletion tracking process. This position is further responsible for the analysis and validation of risk adjustment and quality data that is reported on monthly management reports and monthly output reports to ensure integrity of the reported data. The Manager leads a team that is accountable for the development, maintenance and update of the DataRAP application in alignment with the vision of the organization and CMS requirements.

 

Primary Responsibilities:

  • Provides direction, leadership, and mentoring to Application Development staff
  • Manages the integration of the non-standard Risk Adjustment systems and processes from other LCDO entities into the strategic standard set of systems and processes
  • Develops policies and procedures for system, application and related operational processes in order to ensure optimization and compliance with established standards and regulations internally at Optum Insight and externally with CMS or other regulating body
  • Collaborates with the EDW team in the design of databases, data warehouses, and ETL processes to ensure efficient and effective interoperability with DataRAP solutions
  • Coordinates with all business and technical departments to collect reporting needs and requirements and provide useful reporting solutions to assist in business decisions
  • Ensures that the quality and risk adjustment diagnostic submissions to CMS and/or health plans or their intermediary occur timely and accurately; this includes additions and deletions where appropriate
  • Ensures that the CMS return files received either directly from CMS or from the health plan or their intermediary are reconciled to submitted files
  • Manages the DataRAP application product lifecycle from strategic product planning to tactical activities and provides constructive information to minimize problems and increase customer satisfaction
  • Establishes and enforces software development methodology and processes, including maintenance concerns and support plans. Performs code reviews and other quality improvement tasks
  • Maintains the integrity of source code through defining and enforcing standards and best practices. Maintains a high caliber development staff by encouraging and guiding training of new technologies
  • Performs analysis of, and makes recommendations for the improvement of existing information systems and performs ongoing reviews of new technologies and industry standards and assesses the feasibility of their potential deployment within the organization
  • Fosters a development environment promoting creativity and innovation. Implements processes that take proactive approaches to potential technical problems. Provides oversight and review of technical designs and project plans for development projects
  • Performs all other related duties as assigned

Job IT General Management
Primary Location US-TX-San Antonio
Other Location 
Organization WellMed Medical Mgmt, Inc
Schedule Full-time
Number of Openings 1
Apply on the Company Site

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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