Benefits Systems Manager - Healthcare jobs in Maryland

Jai Medical Systems Managed Care Organization, Inc. was founded in 1997 and serves a diverse population of children and adults throughout the State of Maryland.

Since our founding, Jai Medical Systems’ mission has been to provide high quality healthcare benefits and services to the people of Maryland. We continue this tradition of quality and excellence by working with our members to help identify their healthcare needs, while remaining an active and positive presence within our communities.

Throughout our history of service, Jai Medical Systems has been consistently ranked by the State of Maryland as one of the highest rated Managed Care Organizations for quality. Jai Medical Systems’ commitment to our members and high quality healthcare is demonstrated by our performance in health insurance quality measures, such as HEDIS®. In fact, our HEDIS® scores for key healthcare quality indicators, such as Well Child Checks, Breast Cancer Screenings, and Diabetes Care, are among some of the highest HEDIS® scores in the nation.

Job Responsibilities include:

• Provide support for Pharmacy-related benefit administration including data entry and document preparation.
• Support and implement quality improvement initiatives to improve quality outcomes related to various audits, including HEDIS.
• Participate in the development and implementation of member outreach activities to improve performance.
• Write quality studies; review and participate in the completion of various quality assurance related documents.
• Assist with the preparation and execution of audits and accreditation assessments.
• Support compliance efforts related to various rules and regulations.

Candidate must possess the following minimum requirements:

• Minimum four-year college degree or equivalent experience
• Excellent time management and communication skills
• Basic data management skills
• Problem solving skills
• Organizational skills
• Strong work ethic
• A desire to help others
• A commitment to excellence
• Microsoft Office proficiency (including Word and Excel)
• Pharmacy experience and knowledge preferred
• Experience/knowledge of HEDIS or NCQA desirable, but not required
• Full-time required in-office availability, Monday through Friday 9 a.m to 6 p.m

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Retirement plan
• Vision insurance

Schedule:

• Monday to Friday

Application Question(s):

• Are you available to work full-time required in office hours Monday-Friday 9am-6pm?

Education:

• Bachelor's (Preferred)

Experience:

• Pharmacy: 1 year (Preferred)

Work Location: In person