Healthcare Administrator

$62,400 - $83,200/Yr

A.D. Susman & Associates - Southwest Houston, TX

Full-time - Mid Level

Remote - Southwest Houston, TX

Administrative and Support Services

About the position

The Healthcare Administrator at A.D. Susman & Associates Inc. is responsible for supporting and developing programs that align with the strategic goals of the Health Plan. This role involves effective assessment and equitable distribution of resources, as well as the education and implementation of processes that maintain a cost-effective provider network. The administrator will participate in various committees and workgroups, propose and implement quality control measures, and ensure compliance with standards across departments.

Responsibilities

• Support and develop programs aligned with Health Plan strategic goals.
• Assess and distribute resources and assignments equitably.
• Educate and implement processes and procedures for a cost-effective provider network.
• Participate in Medical Policy and Reimbursement Committee workgroups.
• Facilitate process and system changes as needed.
• Propose and implement quality control measures related to claims adjudication.
• Review current and newly implemented processes for accurate reporting.
• Lead collaborations with other departments to meet compliance standards.
• Manage processes and workflows for audit responses and regulatory compliance.
• Prioritize project tasks and identify risks, issues, and dependencies.

Requirements

• Bachelor's degree (preferred).
• 2 years of experience in healthcare management (required).
• 2 years of experience in medical billing (required).
• Experience with claims and regulatory reporting.
• Experience with Texas Medicaid.
• Experience in Tapestry (preferred).
• Excellent written and verbal communication skills.
• Ability to handle complex situations and achieve effective issue resolution.
• Strong leadership, creativity, integrity, initiative, and problem-solving skills.
• Attention to detail and follow-up.

Benefits

• Hybrid work environment
• Competitive hourly pay of $30 - $40
• Full-time position with a consistent schedule (Monday to Friday, 8-hour shifts)