Provider Relationship and Claims Team Lead

Job Information
Job Title: Provider Relationship and Claims Team Lead
Job Requisition ID: 64299
Ministry: Health
Location: Edmonton
Full or Part-Time: Full Time
Hours of Work: 36.25 hours per week
Permanent/Temporary: Permanent
Scope: Open Competition
Closing Date: November 29, 2024
Classification: Administration 2 (A2)
Salary: $2,400.86 to $3,151.07 bi-weekly ($62,662 - $82,242/year)

The Government of Alberta is committed to a diverse and inclusive public service that reflects the population we serve to best meet the needs of Albertans. Consider joining a team where diversity, inclusion and innovation are valued and supported. For more information on diversity and inclusion, please visit: https://www.alberta.ca/diversity-inclusion-policy.aspx

The Ministry of Health leads work in the areas of Alberta health insurance and benefits, doctors, hospitals and facilities, and other healthcare supports and information. For more information on the work Alberta Health does, visit this link: https://www.alberta.ca/health.aspx

The Health Insurance Programs Branch (HIP) is responsible for administering the Alberta Health Care Insurance Plan (AHCIP) in compliance with Alberta and Canadian legislation and policy. This includes the registration of eligible Albertans, Alberta practitioners and facilities; payment of claims to Alberta practitioners and residents; and special out of province/country programs for Albertans seeking access to medically required health services not available in Alberta and /or Canada.

Role Responsibilities

Reporting to the Manager of Claims, the primary role of the Provider Relationship and Claims Team Lead is to provide leadership and robust decision making for a team of 14 adjudicators responsible for processing In-Province and Medical Reciprocal claims, as well as the registration and maintenance of all health practitioners in the province.

You will be responsible for developing, supervising and evaluating team efforts to provide timely and efficient physician registration, payment processing and responses to general inquiries from practitioners, professional associations and Albertans.

To be successful in this role, you will utilize your knowledge of the Schedules of Medical/Allied Benefits, interprovincial reciprocal agreements, and AHCIP legislation to accurately interpret and apply practitioner registration and claims processing rules. Your proven ability to research, develop, and prepare background information is vital to brief senior management with solutions to both common and unusual problems. Demonstrating your negotiation skills with tact and diplomacy are integral to the position.

Please click on this link to view the job description for this position.

APS Competencies

Competencies are behaviors that are essential to reach our goals in serving Albertans. We encourage you to have an in depth understanding of the competencies that are required for this opportunity and to be prepared to demonstrate them during the recruitment process.

This link will assist you with understanding competencies:
https://www.alberta.ca/system/files/custom_downloaded_images/psc-alberta-public-service-competency-model.pdf

The successful candidate will demonstrate the following APS Competencies:

• Systems Thinking: the work we do is part of a larger integrated and interrelated environment. Considers emerging trends when contributing ideas to the development of broader priorities, strategies and approaches.
• Driving for Results: We all need to take ownership of understanding and achieving results whether as an individual or as a part of a team.
• Develop Self and Others: Ability to develop yourself as well as others is required to supervise and engage staff and ensure a high level of client satisfaction. Ensures that people have the skills for their current work and are developing their competencies to prepare for new challenges.

Qualifications

Minimum Recruitment Standards

Diploma in Health Care, Health Administration, or related field or a minimum of 5 years related experience is required.

• Experience leading/supervising a team and/or team building/coaching experience is preferred.
• Experience in secondary insurance and/or billing/claims/ invoice management is required.
• Experience working with insured/uninsured policies relating to medical services is beneficial.
• Experience with mainframe applications and the Schedule of Benefits is considered an asset.

Equivalences will be considered on the basis of one year of education for one year of experience or one year of experience for one year of education.

Minimum recruitment standards outline the minimum education and experience required for appointment to a job classification.
Refer to https://www.alberta.ca/alberta-public-service-minimum-recruitment-standards.

Notes

This is a full-time position working 36.25 hours per week in Edmonton.

Candidates with lesser qualifications may be considered at a lower classification and salary. This competition may be used to fill future roles at the same or lower classifications.

The final candidates may be required to undergo pre-employment checks (Reference check/Criminal record and/or academic).

A cover letter outlining how your experience relates to the qualifications outlined in this job ad is required.

In your resume, please include dates (including months and years) associated with all education and work experience. Also, please indicate whether your work experience is casual, part-time or full-time. For example, January 15, 2006 - June 25, 2009: Assistant (PT three 8 hrs. shifts/week).

Any costs associated with obtaining the required documents/checks as noted or interview travel expenses, will be the responsibility of the candidate. Out-of-province applicants can obtain the required documents/checks from the province they currently reside in.

What we offer:

• Working for the Alberta Public Service – https://www.alberta.ca/advantages-working-for-alberta-public-service.aspx
• Pension plans:
  • Public Service Pension Plan (PSPP) - https://www.pspp.ca
  • Management Employees Pension Plan (MEPP) - https://www.mepp.ca
• Alberta Public Service Benefit Information - https://www.alberta.ca/alberta-public-service-benefits
• Professional learning and development - https://www.alberta.ca/professional-development-support-directive
• Research Alberta Public Service Careers tool – https://researchapscareers.alberta.ca
• Positive workplace culture and work-life balance
• Opportunity to participate in flexible work arrangements such as working from home up to two days per week and modified work schedule agreement
• Leadership and mentorship programs

How To Apply
Applicants are advised to provide information that clearly and concisely demonstrates how their qualifications meet the advertised requirements, including education, experience, and relevant examples of required competencies.

Candidates are required to apply for a job online. Please visit https://www.alberta.ca/job-application-resources#before for more information. Please visit Recruitment Principles, for more information.

It is recommended applicants who have completed post-secondary studies from outside of Canada obtain an evaluation of their credentials from the International Qualifications Assessment Service (IQAS)(https://www.alberta.ca/international-qualifications-assessment.aspx) or from a recognized Canadian Credential Evaluator; please visit the Alliance of Credential Evaluation Services of Canada for more information (https://canalliance.org/en/default.html).

It is recommended that applicants include the assessment certificate from IQAS or any other educational assessment service as part of their application.

Closing Statement
This competition may be used to fill future vacancies, across the Government of Alberta, at the same or lower classification level.

We thank all applicants for their interest. All applications will be reviewed to determine which candidates' qualifications most closely match the advertised requirements. Only individuals selected for interviews will be contacted.

If you require any further information on this job posting or require an accommodation during the recruitment process, please contact Jagreet Uppal at [email protected].