Join VillageMD as a Cost Containment Manager In Houston or Remote

Join the frontlines of today's healthcare transformation

Why VillageMD?

At VillageMD, we're looking for a Cost Containment Manager to help us transform the way primary care is delivered and how patients are served. As a national leader on the forefront of healthcare, we've partnered with many of today's best primary care physicians. We're equipping them with the latest digital tools. Empowering them with proven strategies and support. Inspiring them with better practices and consistent results.

We're creating care that's more accessible. Effective. Efficient. With solutions that are value-based, physician-driven and patient-centered. To accomplish this, we're looking for individuals who share our sense of excellence, are ready to embrace change, and never settle for the status quo. Individuals who have the confidence to lead but the humility to never stop learning.

Could this be you?

• Integral to our team, as a Cost Contatinment Manager you will leverage your expertise in Medicare Advantage claims payments and processes to ensure payment accuracy. You’ll work in collaboration with our national head of Delegated Services to adopt best practice methodologies and collaborate with vendors and third-party administrators to ensure optimal performance. You’ll need to demonstrate the ability to forge meaningful relationships with external partners.

How you can make a difference

• Responsible for maintaining aged inventory at specified levels as determined by management.
•  Develop metric reports to determine staffing ratios necessary to ensure inventory is managed at the maximum return on investment.
•  Establishes objectives, schedules, and cost data for the business of the function being managedCoordinates activities of unit to meet budget and deadlines and resolves conflicting demands
• Manage and communicate an inventory production schedule to VP and Director of Department.
•  Present weekly and monthly inventory tracking reports to the leadership team.
• Responsible for retaining and hiring new associates as well as the development of an associate training program.
• Presents information to all levels of the organization regarding overpayment results, and makes recommendations for process improvement.
•  Manages and develops direct reports. Directs work assignments, measures results, and initiates personnel actions as required for assigned projects/inventory.
•  Develops and directs the implementation of strategies to improve efficiencies and service provided while reducing costs.
• Plans, conducts and directs work on complex projects/programs necessitating the origination and application of new and unique approaches.
• Acts in a Liaison Capacity with other areas and business units to implement and communicate business strategy as it relates to Cost Containment.
• Acts as a subject matter expert for claim adjustments and overpayment recovery activities.
• Other duties as assigned.

Skills for success

• You are highly skilled at influencing others to achieve results and can pivot between a leadership and support role depending on situation and need
• You are accomplished at distilling complex, technical information to stakeholders at an operational level to effect change
• Experience performing under pressure with a strong sense of urgency, attention to detail, and a commitment to doing what you say you will do
• You are solution-oriented and have a passion for being hands-on in problem-solving and execution
• You are self-starting and maintain a high sense of urgency and accountability in delivering measurable results in line with agreed upon timeframes
• Strong working knowledge in claims processing for Medicare Advantage members based on CMS regulations and guidelines
•  Leadership experience within the claims department of a health plan or delegated provider entity
• Demonstrated expertise in state and federal regulatory claims requirements
• Demonstrated, extensive knowledge of third-party and insurance company operating procedures, regulations and billing requirements, and government reimbursement programs
•  Extensive knowledge and experience with Medicare and Medicaid provider enrollment applications and processes
• You have a keen focus on results, and can navigate within ambiguity while maintaining a high-level of humility

Experience to drive change

• Strong working knowledge in claims processing for Medicare Advantage members based on CMS regulations and guidelines
• Leadership experience within the claims department of a health plan or delegated provider entity
• Demonstrated expertise in state and federal regulatory claims requirements
• Demonstrated, extensive knowledge of third-party and insurance company operating procedures, regulations and billing requirements, and government reimbursement programs
• Extensive knowledge and experience with Medicare and Medicaid provider enrollment applications and processes
• You have a keen focus on results, and can navigate within ambiguity while maintaining a high-level of humility
• 5+ years of experience in a healthcare claims environment as a leader.
• 3+ years of knowledge and experience in claims processing and Medicare rules of regulation

How you will thrive

In addition to competitive salaries, a 401k program with company match, bonus and a valuable health benefits package, VillageMD offers paid parental leave, pre-tax savings on commuter expenses, and generous paid time off. You work in a highly-collaborative, conscientious, forward-thinking environment that welcomes your experience and enables you to make a significant impact from Day 1.

Most importantly, you make a difference. You see a clear connection between your daily work on VillageMD products and services and the advancement of innovative solutions and improved quality of healthcare for providers and patients.

Our unique VillageMD culture – how inclusion and diversity make the difference

At VillageMD, we see diversity and inclusion as a source of strength in transforming healthcare. We believe building trust and innovation are best achieved through diverse perspectives. To us, acceptance and respect are rooted in an understanding that people do not experience things in the same way, including our healthcare system. Individuals seeking employment at VillageMD are considered without regard to race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. 

Those seeking employment at VillageMD are considered without regard to race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status or disability status.

Explore your future with VillageMD today.