Senior Manager of Data Operations
Dynamics of Role
The Senior Manager of Data Operations is primarily responsible for leading a team focused on optimizing all business processes, analytics and decision support tools, and high-volume transaction flow related to Electronic Data Interchange (EDI) within TU Healthcare Insurance Discovery. This includes collaboration with other TU profit and loss centers, as well as any new acquisitions. Additionally, this role will work directly with payers to understand requirements associated for EDI, so that any changes or requests to assist in finding coverage occurs. This role will be responsible for working directly with Insurance Discovery new product requests, application support issues, implementation team, open payer search, Other Health Insurance (OHI), and any other volume requirements to find coverage. These collaborative efforts to optimize EDI business operations and transactions should result in a measurable increase in revenue. This role is responsible for the mission-critical flow of transactions where a single error or improvement can have a negative impact of millions of dollars.
The Team's Focus
TransUnion Healthcare, one of the fastest growing verticals in a $1-billion global company. TransUnion Healthcare, a wholly owned subsidiary of the global credit and information management company TransUnion, empowers providers and payers with Intelligence in an Instant® by providing data and analytics at the point of need. In the provider market, TransUnion offers a series of data and decisioning solutions designed to help providers and patients find financial solutions for needed care. In the payer market, TransUnion offers healthcare analytics and reporting solutions to help payers improve the overall health of their members. The implementation of these solutions is changing the way healthcare is delivered in America
How You'll contribute:
- Complete understanding of process from patient account receipt to found coverage resulting on billable report
- Increase reported coverage by optimizing all EDI transactions and supporting business processes and tools, ensuring we are most efficiently finding more coverage in a timely manner
- Develop and implement standard processes for EDI transaction prioritization, management, monitoring, and reporting
- Identify team and influence efforts focused on generating more found coverage by ensuring all client accounts without coverage are efficiently processed in a thoughtful manner
- Provide metrics on all EDI transactions through various TU Healthcare EDI channels to include government and commercial payers, maximizing the capacity within all TU Healthcare payer connections
- Work directly with Insurance Clearinghouse identifying payers to negotiate volume constraints, making measurable impact on increasing payer bandwidth, remaining cost conscious
- Responsible for making daily, weekly, and monthly recommendations on how to maximize all of TU payer connections, managing costs when applicable, eliminating backlog. Includes making prioritization decisions on competition runs, new installs, Other Health Insurance, and any new products
- Work directly with Application Support when a perceived defect is identified as a broader system issue requiring deep dive analysis to understand why our system did not detect coverage, then influence product enhancements accordingly
- Work directly with Global Technology EDI team to understand what new enhancements are in the pipeline, when the changes will be made, and monitor impact of those changes, communicating the impact of the change, including revenue impact
- Work directly with Product to assist with prioritization of PI planning efforts for all EDI changes, as well as understanding how our existing product works and identifying enhancement opportunities
- Proactively identify system and query configuration issues and ensure resolution and tracking of impact post fix
- Exercise sound judgement in deciding how transactions will be prioritized on a regular basis, to include new products, implementation priorities, OHI, and Other Payer Search (OPS), and effectively communicate and set expectations with all necessary functional areas
- Proactively communicate to proper stakeholders any changes in EDI transactions that will impact revenue. This includes all insurance discovery offices
- Provide assistance to any new products being created with clients seeking a solution to find coverage in greater volume and faster
- Make recommendations using strong business acumen to best organize team to maximize finding coverage through optimization of EDI transactions flow and associated business operations
- Own customer account throttling programs
- Understand and track how found coverage flows to billable reports
What You'll bring:
- Relentless Change Agent
- Leadership to a team passionate about proactively monitoring and optimizing EDI transactions on a daily basis
- Tireless drive to be the best insurance discovery team in healthcare
- Motivated, organized, collaborative, and engaged work style
- Bachelor's degree in business, marketing, communications, computer science or related field required. Masters Preferred
- Minimum of 8 years of healthcare and/or payer experience preferred
- Proven ability to exercise sound judgment making decisions that have multi-million dollar business impact
- Proven ability to lead analytical teams in the EDI trade
- Proven ability to perform the overall duties and responsibilities of this position with minimal direction
- Technical acumen or proven ability to lead technical resources
- Strong sense of professionalism and personal accountability
- All other comparable tasks as assigned in special projects
What We Offer
Committed, Responsive, Open, Thoughtful, Engaged.
Our success is rooted in a few simple values: integrity, service, reliability, and performance. These values give our customers the power to achieve their goals. We think of ourselves as a start-up company with a trusted pedigree. We pride ourselves on fostering a fun, friendly work culture that allows associates at every level the opportunity to make meaningful contributions to innovative projects – and allows them a life outside the office. Our salaries and benefits are highly competitive – designed to attract and retain great talent. And our engaged and accessible senior staff members pride themselves on creating opportunities for associates to collaborate, grow, and advance.
Who We Are
A global leader in credit information and information management services, TransUnion gives businesses, consumers and the global community the power to achieve their goals. Businesses count on us to better manage risk and customer relationships. Consumers are able to better manage credit to achieve their financial goals. And in communities around the world we help build strong economies and give people the power to achieve their dreams.
Exceptional opportunities are coming as we build on this strong foundation. Our ambitious growth strategy includes substantial new investment worldwide, a wide range of new solutions to help our customers succeed like never before, and new ideas for expanding our reach in every part of our dynamic and fast-moving industry. We're on an exciting journey and you can be a part of it.
We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability status, veteran status, marital status, citizenship status, sexual orientation, gender identity or any other characteristic protected by law.
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