TriWest Healthcare Alliance

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Recruiting Location Phoenix, AZ
ID 2020-3222
Manager, Subcontract Management at TriWest Healthcare Alliance   Taking Care of Our Nation’s Veterans. It’s Who We Are. It’s What We Do.   Do you have a passion for serving those who served?   Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve®!   Our job is to make sure that America’s heroes get connected to health care in the community.   At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996.   The Subcontract Management Manager is responsible for supporting the managing the contractual relationships with TriWest’s key operation’s subcontractor(s), and serves as one of the key points of contact for implementation issues, day-to-day performance monitoring, resolution of contractual-related issues, and participates in renegotiation of contract structure and setting and updating of performance standards and the associated metrics. The Manager may assist with ensuring that the subcontractor fully understands and meets all regulatory and contract requirements, to include internal policies and procedures, and reporting out to Senior Leadership on the performance against agreed upon metrics. In addition to monitoring performance, the Manager assesses, identifies and communicates opportunities for operational and management changes to achieve improved effectiveness, efficiencies and quality. The Manager diagnoses issues and develops solutions in conjunction with stakeholders to drive improved results.
Recruiting Location Phoenix, AZ
ID 2020-3221
Are you a driven and independent individual? Do you have healthcare and/or project management experience? Do you expect great results out of yourself and others? If so, we might be a fit. TriWest Healthcare Alliance has been on a Mission to serve our nation’s Veterans and their families since 1996. We are an evolving team of professionals that will do “Whatever it Takes” to serve our nation’s heroes in partnership with the VA. We are looking for talented individuals with a unique blend of skills to advance our organization through project management.    The Senior Program Manager is responsible for ensuring that enterprise wide programs are well defined, planned, tracked and communicated in a consistent manner; responsible for building partnering relationships within stakeholders; responsible for on time, within budget and quality implementation of enterprise wide programs; responsible for executing project management best practices. 
Recruiting Location Phoenix, AZ
ID 2020-3220
Taking Care of Our Nation’s Veterans.   It’s Who We Are. It’s What We Do.   Do you have a passion for serving those who served?   Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve®!   Our job is to make sure that America’s heroes get connected to health care in the community. At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996.   Are you our next Sr. HRIS Analyst?     Provides Human Resources Information System (HRIS) support to Human Resources staff.  Coordinates the development and maintenance of the HRIS database, HRIS-related analytics, and systems-related processes.  Monitors system processing and tracks department administrative activity to ensure data integrity.  Oversees daily HRIS operations for internal control purposes.  Coordinates the mechanics of system processing, tracking of confidential information, and related PeopleSoft forms.  Develops and maintains query reports for user groups.  Collaborates with IT staff on system issues and problem resolution.  Coordinates system enhancements and modifications on the end user side.  Assists with PeopleSoft implementation issues and works with other HRIS staff on daily operational issues.  Functions as a department resource on PeopleSoft system training.
Recruiting Location Phoenix, AZ
ID 2020-3219
This is a Financial position in Phoenix, AZ   Sr Financial Workload Analyst at TriWest Healthcare Alliance   Taking Care of Our Nation’s Veterans. It’s Who We Are. It’s What We Do.   Do you have a passion for serving those who served?   Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve®!   Our job is to make sure that America’s heroes get connected to health care in the community.   At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996.   Are you our next Sr Financial Workload Analyst?
Recruiting Location Phoenix, AZ
ID 2020-3218
Taking Care of Our Nation’s Veterans.   It’s Who We Are. It’s What We Do.   Do you have a passion for serving those who served?   Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve®!   Our job is to make sure that America’s heroes get connected to health care in the community. At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996.   Are you our next Sr. Internal Auditor?     This position is under the direct guidance of the Manager, Internal Audit for administrative purposes and project management.  This position will work with the Manager, Internal Audit and the Director, Corporate Compliance to establish and conduct a risk based program for testing internal controls to prevent and detect fraud, waste and abuse; assess efficiencies of processes; and to evaluate compliance with contract requirements. This position may also assist our external financial auditors in performing testing as needed.
Recruiting Location Phoenix, AZ
ID 2020-3214
Manager, Physical Security/Facilities at TriWest Healthcare Alliance   Taking Care of Our Nation’s Veterans. It’s Who We Are. It’s What We Do.   Do you have a passion for serving those who served?   Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve®!   Our job is to make sure that America’s heroes get connected to health care in the community.   At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996.   Under the direction of the Director of Facilities is responsible to organize, direct, coordinate and oversee all aspects of facilities and physical security activities at corporate and nationally for TriWest. Activities range from facilities operations, maintenance and construction, and disaster recovery/business continuity operations; manage company distribution services to include shipping and receiving; oversee 24/7 Security Operations Center (SOC) operations and all physical security requirements for TriWest corporate and commercial offices.  
Recruiting Location Phoenix, AZ
ID 2020-3209
Business Intelligence Analyst at TriWest Healthcare Alliance   Taking Care of Our Nation’s Veterans. It’s Who We Are. It’s What We Do.   Do you have a passion for serving those who served?   Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve®!   Our job is to make sure that America’s heroes get connected to health care in the community.   At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996.     The Business Intelligence Analyst is customer focused and facilitates turning data into information to drive business processes and monitoring. The position collaborates to ensure relevant analysis and complete, timely reporting is provided to meet TriWest business needs and Veteran’s Administration’s Healthcare requirements. Facilitates meetings, identifies, collects, organizes and prioritizes data requirements and business processes changes to meet reporting requirements. Clarifies complex business issues and recommends solutions. Advocates business process improvement through data analysis, process change and technology application.  
Recruiting Location Phoenix, AZ
ID 2020-3207
Job SummaryThis position is responsible for providing leadership in the development, implementation and oversight of all Provider Data and Credentialing functions in alignment with organizational strategic initiatives while ensuring a collaborative, open and inclusive work environment that is focused on quality outcomes and superior customer service. Accurate provider data and credentialing is central to pay or organizations so this position must drive for timely data processing with highest degree of accuracy possible. This position serves as the primary advisor to the organization and subject matter expert on matters related to assigned area of responsibility. Also directs, plans, develops, and implements performance standards, quality improvement, and delivery of service to create a positive impression of TriWest with its providers. This position is responsible for serving as a role model throughout the organization and representing TriWest in a positive manner both within and outside the organization.Education & ExperienceRequired: •Bachelors degree in Business Administration, Health Care or related field or equivalent experience•5 years experience in a Managed Care environment•5 years management experience in the healthcare industry•At least 3 years experience with provider data management, credentialing and/or provider services operations•Ability to manage large numbers of staff in a production environment•Experience in strategic planning, program management/implementation, and staff development•Experience with URAC , NCQA or other equivalent accreditation standardsPreferred: •Experience in government healthcare delivery programs, such as Veterans Affairs, TRICARE and MedicareKey Responsibilities•Responsible for leading the Provider Services Provider Data Management and Credentialing Department of ~30-40 staff members and supervisors. Provides leadership and direction to ensure department adherence to established performance metrics. Optimizes individual team member performance through mentoring and coaching.•Manages the entry of data into the provider master database which houses all network provider information. Coordinates and monitors data entry interface from outside organizations and oversees the maintenance of up-to-date information, including provider demographic data, contracting, provider directory, and status information. Oversees and directs the source verification and data entry process. Develops key performance reports/dashboards to communicate department performance to senior leadership and other key areas within the organization.•Ensure the accuracy of all network provider data which exceeds industry standards.•Identify, implement and maintain several systems as the business owner to support the necessary functions within the department. •Leads database enhancement initiatives and IT interface on database and system changes. Develops and maintains standards for data integrity and identifies system issues integral to problem resolution.•Oversees, develops, and directs the implementation of credentialing and re-credentialing policies to meet contract (e.g. Department of Veterans Affairs) and accreditation (e.g. URAC) requirements. Oversees and implements credentialing audit plan with the network subcontractors and other delegated entities. Reviews and reports the results of audits to the Corporate Clinic Quality Management Committee. Oversees the implementation of strategic plans and reinforce working with providers to meet or exceed network targets. Manages the annual review of credentialing policies and procedures to ensure accuracy and compliance with contract and accreditation requirements.•Develops strong network provider relationships and work towards effective identification and timely resolution of provider data processing issues. Ensures timely responses to provider questions and issues. Resolves reoccurring issues through appropriate problem identification and new strategies. Develops process improvements and implementation plans for workflow procedures and service levels. •Responsible for ensuring all network provider contract terms are loaded into the appropriate systems to allow for accurate authorization and referral management and claims processing..: •Defines staffing needs and allocates resources to achieve service objectives. Selects staff, orients, trains, coaches, and develops staff.•Determines budgetary requirements for meeting department objectives. Recommends annual budget and supporting business cases for system enhancements. Forecast resource requirements in response to industry trends and developments.•Works collaboratively with external entities to ensure continuous quality improvement.•Regular and reliable attendance is required.CompetenciesCoaching / Training / Mentoring: Actively foster actions required for desired business outcomes through ongoing constructive feedback.Communication / People Skills: Ability to influence or persuade others under positive or negative circumstances; Adapt to different styles; Listen critically; Collaborate.Computer Literacy: Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications.Coping / Flexibility: Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach is required.Empathy / Customer Service: Customer-focused behavior; Helping approach, including listening skills, patience, respect, and empathy for another's position.Independent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; Commitment to task to produce outcomes without direction and to find necessary resources.Information Management: Ability to manage large amounts of complex information easily, communicate clearly, and draw sound conclusions.Leadership: Successfully manage different styles of employees; Provide clear direction and effective coaching.Multi-Tasking / Time Management: Prioritize and manage actions to meet changing deadlines and requirements within a high volume, high stress environment.Problem Solving / Analysis: Ability to solve problems through systematic analysis of processes with sound judgment; Has a realistic understanding of relevant issues.Team-Building / Team Player: Influence the actions and opinions of others in a positive direction and build group commitment.Technical Skills: Knowledge of relational databases, Knowledge of credentialing principles, practices, and standards; Strong leadership skills to lead major systems change processes; Technical systems knowledge to manage IT interface on systems issues; Knowledge of health care systems organization, administration, and service delivery; Collaboration skills, with ability to build external relationships to achieve positive outcomes; Knowledge of state and federal regulations governing health care systems and practices; Knowledge of cost control methods for operational systems; Program development experience; Knowledge of professional practice standards, quality improvement, and research activities for large health care systems; group presentation skills; Training and development skills for mentoring technical skills of staff.
Recruiting Location Phoenix, AZ
ID 2020-3204
Job Summary    Directs multiple large TriWest projects, working closely with program managers, project managers and business leaders to understand and report quality and performance issues and address systemic concerns. Diagnoses and implements solutions.   Conducts quantitative and qualitative analysis and assessment of TriWest programs, processes, and outcomes. Utilizes quantitative tools and techniques to perform data-based analysis.   Utilizes consulting and facilitation approaches for qualitative assessments. Produces complete and informative, reports, describes options in terms of cost/benefit, and makes recommendations to leadership and/or user groups for process/program improvement and/or decision-making.   Supports project implementation when required using project management tools to develop project plans/timelines, coordinate/manage project, monitor and report status, progress and areas of risk in relation to established project objectives, requirements and timelines.   Works quickly and thoroughly to perform analyses, report results, produce deliverables and support implementation on time.