Decision Support Manager

The Center for Elders’ Independence is a PACE (Program of All-Inclusive Care for the elderly) organization (PO) that uses an interdisciplinary team approach for care planning and implementing purposeful high quality, affordable, and integrated health care services to the elderly. Our elderly meet PACE requirements as prescribed by CMS and are referred to as participants. Our PO includes Adult Day Health Centers and primary care clinics, promoting participant autonomy, quality of life and the ability for individuals to live in their communities.

THE POSITION :

The Decision Support Manager performs and oversees the development of modeling, reporting, research, and analysis on internal financial and operational data, along with external market analysis using various tools for the purpose of providing operational insights and strategic planning. Provides project management and leadership in the implementation of key departmental initiatives. Responsible for effective maintenance of future Decision Support systems and data through regular audit driven oversight and documentation of processes. To be effective in this role the Manager, Decision Support will be highly motivated and possess advanced critical thinking skills, highly developed analytical ability, and be an effective communicator with all levels of the organization.

The salary range for Decision Support Manager position at Center for Elders’ Independence is $143,944-$230,310 per year.  The salary is based on the market for the Decision Support Manager as well as experience, skills, abilities and work history.

DUTIES AND RESPONSIBILITIES :

• Develop annual budget, review and analyze monthly budget variance and trends, identify opportunities to realign departments to budget
• Obtain, validate and analyze data for resource, expenditure, capital, strategic planning requests, and present analysis results
• Maintain position control, review cost center labor metrics, and assist cost centers with maintaining resources within metrics
• Work with departments to identify opportunities for efficiencies, utilize project management skills to prioritize and implement system, tool, process and other initiative, establish metrics and benchmark to measure progress and success
• Build relationships with departments and become their trusted financial advisor
• Develops, manages, and maintains various reports including profitability, service level, volume, financial and other ad hoc reports.
• Identifies improvement opportunities through benchmarking of goals and trend analysis.
• Maintains optimal functionality and enhancement of Decision Support systems including data integrity through audits and workflow documentation to ensure optimal platform performance.
• Developed and guided the Capitation Rate Development staff, familiar with including prospective and historic program changes not fully reflected in the base data. Experience in observed changes in population case-mix and underlying risk of plans form the base data. Familiar with trend factors to forecast the expenditures and utilization to the contract period.
• Familiar with the Medicare Part D bid process. Have experience in collaborating with Actuaries and provide guidance to the team.
• Responsible for the annual budget process and familiar with Budgeting software such as Workday Adaptive.
• Oversee IBNR, RDT, Part D, and regulatory report preparation and submissions.
• Maintaining an understanding of PACE Hierarchical Condition Category (HCC) Coding as well as paying careful attention to the PACE HCC reimbursement model.
• Responsible for overseeing the Encounter data analyst’s submission as well as auditing all monthly and ad-hoc outbound encounters / HCC reporting. Also responsible for analyzing along with the Encounter Data Analyst the inbound reports.
• Establish and maintain strong relationships with Encounter Clearing Houses, external auditors / vendors, and internal stakeholders to fix, prevent, and to obtain extra support in resolving encounter and HCC coding errors.

QUALIFICATIONS :

The above job description is intended to communicate the general function of the mentioned position and by no means shall be considered an exhaustive or complete outline of the specific tasks and functions that will be required. CEI reserves the right to change job descriptions, site assignments, and or work hours as required by the needs of the program. All employees are expected to perform their duties within their ability as required by the job and / or as requested by management.

SUPERVISED BY : Controller

POSITION SUPERVISES : A Decision Support Analyst, a Budget Analyst, and an Encounter Data Analyst.

Center for Elders’ Independence is a PACE (Program of All- Inclusive Care for the Elderly) organization that uses an interdisciplinary team approach to care planning and care implementation for the purpose of providing high quality, affordable, integrated health care services to the elderly, including an Adult Day Health Center, and promoting autonomy, quality of life and the ability of individuals to live in their communities. Unlike other healthcare plans, CEI is not a "fee-for-service" plan. It is a “capitation” healthcare plan. CEI is paid a set amount for each person enrolled in our program, whether or not that individual seeks care. We are a growing company that offers stability and continues to thrive.