TMG Health is always looking for talented and energetic
individuals to join its team. Listed below are the current job openings
and accompanying job descriptions.
We are especially seeking candidates with the following
experience:
• Health insurance industry
• Medicare or Medicaid health plans
• Health plan financial accounting
• TriZetto Facets Medical Management System
ACCOUNT MANAGER Reports to: Director of Account Management
Location: Dunmore, PA
Summary of Position: This position entails customer satisfaction, attaining
contractual revenue expectations, realizing additional “up sell”
revenue opportunities, and general mediator for issue resolution. These
goals will be achieved by direct involvement in all implementation and
ongoing client services throughout the life of the client for all assigned
clients. The account manager will become knowledgeable in all aspects
of TMG client programs and their regulatory and contractual requirements.
Principal Duties of Position:
Primary point of contact for the account’s director level and
above personnel
Create and maintain a detailed and mutually agreed to customer account
plan
Hold frequent status meeting with customer and TMG Health personnel
Track and report on the status and estimated completion dates of
all outstanding issues, problems, tasks, goals and deliverables
Report on a monthly basis TMG performance against contractual performance
measures
Document all relevant client issues and communications in Salesforce
Inform and facilitate the involvement of the account’s Executive
Sponsor when needed to ensure timely and expedient resolution of outstanding,
high priority issues
Ensure participation of the appropriate personnel from the account
in TMG’s annual client satisfaction survey as well as client oriented
events
Represent the customer’s interest and needs and ensure that
all TMG resources are willingly committed to resolving the customer’s
issues
Education and Experience:
Bachelor’s degree required; Master’s a plus
Seven to ten years operations experience within a health plan related
environment
Successful project management experience
Supervisory or direct client responsibilities preferred
Prior training and/or experience with CMS and HIPAA regulations
Other Skills and Abilities:
Excellent customer communication skills including objection handling
Project management skills
Influence skills
Exemplary communication and organizational skills
Thrive in a fast paced environment
Deadline oriented and attentive to detail
Proficiency in MS Word Excel, Access, and MS Project
Interested applicants may click
here to attach resume or send resume with salary requirements to:
TMG Health, Inc.
Attn: Human Resources Department
1205 O'Neil Highway
Dunmore, PA 18512
ATTESTATION
ANALYST Reports to: Reconciliation Manager
Location: Dunmore, PA
Summary of Position: The purpose of this position is to monitor the
entire reconciliation for TMG’s attestation reporting process. The
position involves running reports, analyzing data, creating corrective
action plans for discrepancies to be processed, creating financial reports
and reviewing all data with the plans on a monthly basis. The position
is highly technical and the associate will need not only to run and prepare
the reports but also explain the data and know how the problems have arisen.
Principal Duties of Position:
Solid understanding of the Facets Enrollment System
Solid understanding of how to understand and interpret the CMS MARX
system
Ability to use Microsoft Excel and word applications
Ability to use Microsoft Access to assist in analyze discrepancy
information
Ability to understand how CMS guidelines apply in order to understand
how discrepancies have been created
Must be able to learn how to run and download all reports that are
generated from our Processing agent
Must be able to understand how discrepancy reports are created.
Must be able to research and analyze all discrepancies to determine
the root cause of the issue.
Must be able to develop corrective action plans for each discrepancy
that occurs and how the discrepancy will be corrected.
Must be able to categorize discrepancies correctly. Discrepancies
can be caused by CMS, TMG or our IT processor.
Must be able to clearly communicate all discrepancy issues on a monthly
basis to plan.
Needs to be able to follow up on all issues and communicate a plan
to the client indicating when all discrepancies would be resolved.
Must be able to communicate with all enrollment and billing staff
to determine the root of cause of a discrepancy and why it occurred.
Must be able to provide feedback to processing teams on the correct
way to update a transaction if an error did occur.
Must be able to work with CMS in order to resolve all issues related
to CMS processing errors.
Must have diligent follow up skills to make sure all open items are
cleared from one reporting period to another. Discrepancies cannot flow
from one reporting period to another. The analyst must be able to track
all discrepancies on a weekly basis to ensure discrepancies are resolved.
Must be able to clearly articulate and explain all final reports
to senior level management.
Education and Experience:
Bachelor's degree (B. A.) from four-year College or university; or
one to two years related experience and/or training; or equivalent combination
of education and experience.
Ability to read, analyze, and interpret common scientific and technical
journals, financial reports, and legal documents.
Ability to respond to common inquiries or complaints from customers,
regulatory agencies, or members of the business community
Ability to effectively present information to top management, public
groups, and/or boards of directors.
Ability to work with mathematical concepts such as probability and
statistical inference, and fundamentals of plane and solid geometry
and trigonometry.
The individual has the ability to apply concepts such as fractions,
percentages, ratios, and proportions to practical situations.
Ability to apply principles of logical or scientific thinking to
a wide range of intellectual and practical problems.
Individual possesses the ability to deal with nonverbal symbolism
(formulas, scientific equations, graphs, musical notes, etc.) in its
most difficult phases.
Individual has the ability to deal with a variety of abstract and
concrete variables.
Other Skills and Abilities: The position of attestation analyst requires a
person to not only be technically savvy but also be able to analyze and
draw conclusions based on reporting results. The analyst will need to
be able to complete an action plan and to ensure that all discrepancies
are resolved in a timely basis and within the CMS guidelines. In addition
to this the analyst must be able to communicate this data to the plan
and with management levels within TMG. This person must be able to do
all functions related to the monthly reconciliation process.
Interested applicants may click
here to attach resume or send resume with salary requirements to:
TMG Health, Inc.
Attn: Human Resources Department
1205 O'Neil Highway
Dunmore, PA 18512
Summary of Position: This position is responsible for processing claims
in the claims processing system of Facets.
Principal Duties of Position:
Data entry of claims into claims processing system
Adjunction of claims in the claims processing system
Working pending claims on a daily basis
Maintain quality standard of at least 98%
Resolve claim inquiries on a timely basis
Maintain productivity at a level to ensure minimal client backlog
Education and Experience:
High school education required
Other Skills and Abilities:
Keyboard skills
Demonstration of ability to use good judgment and logical reasoning
Ability to work overtime as required by management
Flexibility to varying project assignments
Ability to work in a fast paced, highly regulated environment with
extreme accuracy
Interested applicants may click
here to attach resume or send resume with salary requirements to:
TMG Health, Inc.
Attn: Human Resources Department
1205 O'Neil Highway
Dunmore, PA 18512
COMPLIANCE
ANALYST Reports to: Director/Corporate Compliance
Location: Dunmore, Pa
Summary of Position: To perform this job successfully, an individual
must be able to perform each essential duty satisfactorily. The requirements
listed below are representative of the knowledge, skills, and/or ability
required.
Principal Duties of Position:
Working under the direction of the Company’s Corporate Compliance
Director to support the monitoring, development and implementation of
the Company's Compliance Plan and related compliance policies and procedures
Under the direction of the Corporate Compliance Director, taking
all reasonable measures necessary to carry out the Company's Compliance
Plan and the accomplishment of its objectives, and to ensure that the
components of the Plan are incorporated into, and an integral part of,
the Company's operational policies and procedures
Government Programs Compliance
Monitors information and directives from various federal agencies
for compliance issues, including the Centers for Medicare and Medicaid
Services (CMS). Reviews each document and assigns to corresponding Business
Owner(s). Coordinates with Business Owners in analyzing the information
and obtaining Impact Statements for impact on TMG operations and its
customers. Coordinates with Business Owners to updates on open and outstanding
Impact Statement tasks. Coordinates with Account Managers in communicating
and operational changes or recommendations to TMG’s customers
Assists the Compliance Director as requested in serving as the TMG
liaison with customers and government agencies for activities such as:
Responding to official inquiries
Clarification and interpretation of compliance rules/requirements
Preparation for Monitoring Reviews and other audits
At the direction of the Compliance Director, Company’s legal
counsel and/or outside counsel, taking all reasonable steps to ensure
that the Company and its employees cooperate and comply with any requests
and/or demands made by CMS, HHS, OIG or other Federal or state government
agency made in the course of an investigation, inquiry or audit;
Assists and supports the Compliance Director in investigating and
acting on matters related to compliance and the development and documentation
of corrective actions involving any violations of policy by employees
or contractors;
HIPAA Compliance
As directed, assists the Company’s Privacy Official, working
under the direction of the Company’s General Counsel and Corporate
Compliance Officer, on the implementation and monitoring of the Company’s
Protected Health Information Plan, all Transactional, Privacy and Security
Standards of the Health Insurance Portability and Accountability Act
(“HIPAA”), and related Federal and state regulatory requirements
involving Protected Health Information (“PHI”) or data,
or other confidential or protected information.
Assists in the investigation of and documents reported HIPAA related
issues/concerns of TMG’s customers.
Responsible for the investigation and documentation of Claims related
PHI disclosures and HIPAA incidents.
Assists the Compliance Director in coordinating with the Company’s
Security Official, SVP Operations and IT, and any other necessary Department
Heads and staff to ensure that the company complies with all HIPAA requirements
concerning the transmittal and handling of PHI.
Human Resources and Employee Training
Responsible for ensuring that all employee changes, including new
hires, terminations and departmental moves, are documented in the Compliance
Training system. Coordinates with the company’s Human Resource
Department and IT Security to ensure the Compliance Training system
is updated and to ensure that all employees receive proper compliance
training prior to receiving access to Protected Health Information
Assists the Compliance Director in the coordination with the Company’s
Human Resource Manager to ensure proper employee screening, as may be
required by Federal or state law, and in particular that that the General
Services Administration’s List of Parties Excluded from Federal
Programs and the List of Excluded Individuals/Entities of the U.S. Department
of Health and Human Services ("HHS"), Office of Inspector
General ("OIG") has been checked with respect to all employees
and independent contractors upon hire and annually thereafter.
Education and Experience:
Bachelor’s Degree with health care experience preferred
Other Skills and Abilities:
Ability to work scheduled hours. Overtime may be required, including
evenings, nights, weekends, and holidays.
Ability to read, analyze and interpret general business periodicals,
professional journals, procedures, or government regulations. Ability
to write reports, business correspondence and policy and procedure manuals.
Ability to effectively present information and respond to questions
from managements, peers and clients.
Interested applicants may click
here to attach resume or send resume with salary requirements to:
TMG Health, Inc.
Attn: Human Resources Department
1205 O'Neil Highway
Dunmore, PA 18512
CUSTOMER SERVICE
REPRESENTATIVE Reports to: Customer Service Supervisor
Location: Dunmore, Pa
Summary of Position: This position is responsible for receiving, researching,
resolving and documenting member and provider inquiries, (written, telephonic
and electronic) and member grievances, receiving and making outbound calls
to members regarding health risk assessment, working aged surveys, and
assisting operations area as needed.
Principal Duties of Position:
Receive, research, resolve and document member and provider inquiries
Receive, research and respond to client inquiries
Receive, research, resolve and document member complaints/grievances
Receive identify, document and route member appeals to client
Receive telephone inquiries regarding health risk assessment and
working aged surveys, etc.
Contact health risk assessment and working aged non-respondents by
telephone
Ensure compliance with state and federal laws
Maintain effective relationships with external and internal customers
Assist operations area as needed
Education and Experience:
Minimum one to two years business experience, customer service and/or
healthcare related experience
Other Skills and Abilities:
Excellent verbal and written communication skills
Working knowledge of MS Word, Excel and Outlook
Excellent telephone and typing skills. Must be able to talk/listen
and type simultaneously
Demonstrate ability to use good judgment and logical reasoning
Ability to make sound decisions
Excellent attention to detail
Working knowledge of healthcare policies/procedures helpful
Accurate data entry skills
Must be a team player
Interested applicants may click
here to attach resume or send resume with salary requirements to:
TMG Health, Inc.
Attn: Human Resources Department
1205 O'Neil Highway
Dunmore, PA 18512
CUSTOMER
SERVICE SUPERVISOR (EVENINGS) Reports to: Customer Service Manager
Location: Dunmore, Pa
Summary of Position: Supervisor positions will be dedicated to providing
direction to the Customer Service Department during hours of operation,
Monday through Friday, 8:00AM – 9:00PM. Shifts for the Supervisor
will be AM start. (Extended hours, holidays and weekends will be applicable
when business needs arise.)
Principal Duties of Position:
Performs both on demand and pro-active services for the clients, members
and providers serviced by TMG Health
Establish departmental goals and objectives as well as assist in
the achievement of Company objectives
Identify and establish duties and responsibilities for each team
member of the Customer Service Department
Administer training to Customer Service Representatives regarding
Company policies and procedures
Maintain and manage productivity reports generated by the Call Center
systems
Establish and implement productivity measures (KPI’s –
Key Performance indicators) and coach/monitor service representatives
to attainment
Review, track and analyze subordinate performance(KPI’s) including
identifying training needs, appropriate follow up, conduct coaching/monitoring
sessions and performance improvement plans (CAP/PIP)
Conduct meetings with the customer service team to keep employees
abreast of daily changes in policy, procedures and services
Develop an efficient and harmonious work group
Set and maintain high quality customer service standards
Ensure efficient utilization of work force and work load and proficiency
in call center staffing
Develop and implement projects and plans to improve efficiencies
and operating results
Education and Experience:
BA or equivalent in Business Administration or Healthcare; or six
years total business experience
Minimum of one year supervisory experience
Other Skills and Abilities:
Ability to read, analyze and interpret general business periodicals,
professional journals, procedures or government regulations
Ability to write reports, business correspondence and procedure manuals
Ability to complete data analysis and associated reports
Ability to interpret extensive variety of medical detail and deal
with several abstract and concrete variables
Must be highly organized, self-confident, focused on goals, have
the ability to stay motivated and motivate others, possess strong leadership
skills, presentation skills, oral and written communication skills,
and the proven ability to coach and train others to success
Must be fluent in the use and navigation of a Windows environment;
Excel, Word, Power Point, Access and all of TMG Health’s customer
service systems
Must possess solid product knowledge and have excellent written,
verbal and presentation skills
Must have exceptional customer service skills and capable of multi-tasking
Interested applicants may click
here to attach resume or send resume with salary requirements to:
TMG Health, Inc.
Attn: Human Resources Department
1205 O'Neil Highway
Dunmore, PA 18512
EBR IMPACT
TEAM SPECIALIST Reports to: Enrollment Manager
Location: Dunmore, PA
Summary of Position: The EBR Impact Team Specialist will be directly
involved with reviewing CMS directives, developing CMS Impact statements,
assigning management responsibilities and completion dates, tracking deliverables,
and providing status updates to TMG Management, EBR Team, and Compliance.
Principal Duties of Position:
Receive and review all CMS documents for operational impact; EBR assigned
for action as appropriate; ensure all changes are included on any implementation
task list; and distributed documents to enrollment, billing and recon
management as appropriate.
Develop Impact Statements for Urgent CMS items within 2 business
days of receipt. For all other CMS documents, impact statements must
be developed within in 5 business days
Forward Impact statements to those on the Impact statement distribution
list (ensuring management received all updates and statements) and all
management assigned having responsibility for an impact statement.
Track all impact statements and tasks in the EBR Impact Tracking
Log
Provide weekly update to EBR Team and Compliance Department regarding
all CMS documents assigned to Enrollment, Billing, and Recon
Communicate daily if necessary with management in Enrollment, Billing
and Reconciliation to review new directives and impact statements
Meeting weekly with Enrollment, Billing and Reconciliation Management
to review all directives and to monitor implementation status of all
directives.
Obtain all supporting documentation from Enrollment, Billing and
Reconciliation management to verify implementation including Impact
Document signoff sheet and forward to Compliance.
Notify TMG Compliance and EBR Team should TMG be in jeopardy of being
out of compliance with any impact statement or CMS document
Distribute draft regulations and impact statements to Enrollment
management for review and comment
Collate Enrollment, Recon, and Billing management comments and communicate
progress to TMG Compliance department
Collaboration with other departments as necessary
Education and Experience:
Minimum of 3 years healthcare experience
Previous experience with project management including assigning and
tracking deliverables required
Strong knowledge of Medicare regulations preferred
College degree is preferred but not required. Years of service can
be substituted for a degree.
Other Skills and Abilities:
Must possess solid product knowledge and have excellent written, verbal
and presentation skills.
The incumbent must be capable of handling multiple tasks simultaneously
and must remain self confident and professional when representing TMG.
Must be detail oriented, able to interpret CMS regulations, self
directed and able to work with minimal supervision.
The incumbent must also be able to work under pressure with strict
timeframes, have strong organizational and prioritization skills along
with a working knowledge of MS Word and Excel.
Proven experience in enrollment, billing or reconsiderations processing
with technical knowledge of Facets and department procedures.
Excellent interpersonal skill with an ability to effectively communicate
with both internal and external customers.
Candidate must have the ability to work in a team environment and
possess solid project management skills.
Excellent technical or business writing skills are also required.
Interested applicants may click
here to attach resume or send resume with salary requirements to:
TMG Health, Inc.
Attn: Human Resources Department
1205 O'Neil Highway
Dunmore, PA 18512
ENROLLMENT AND
BILLING REPORTING ANALYST Reports to: Enrollment Manager
Location: Dunmore, PA
Summary of Position: This position will provide essential planning and
analysis around performance metrics, recommend process improvements, identify
trends related to performance, and create internal and client communications
on all performance standards.
Principal Duties of Position:
Provide ongoing analysis on performance standards using productivity
volume indicators
Perform gap analysis and prepare documentation indicating improvement
measures
Provide operational and analytical support in the enrollment department
Own reporting requirements for the department
Own the requirements for metric reporting within the enrollment department
and maintain responsibility for working with department managers on
consistent report tracking
Participate in various initiatives to define, analyze, and recommend
solutions to address current reporting processes
Provide metrics and reports to track receipts through submissions
to CMS
Education and Experience:
College degree preferred
Minimum 3 years experience of operations and analysis or similar
experience preferred
Minimum 2 years experience in enrollment, billing, and reconciliation
processing a plus
Other Skills and Abilities:
Strong knowledge of Medicare regulations
Strong quantitative abilities with experience in data gathering and
analysis
Ability to work in a fast paced environment, under pressure, with
strict timeframes
Microsoft Excel, Power Point, and Word application expertise
Strong collaboration and communication skills
Independent problem solving, time management, and multi-tasking skills
Must be detail oriented, able to interpret CMS regulations, self-directed,
and work with minimal supervisions
Interested applicants may click
here to attach resume or send resume with salary requirements to:
TMG Health, Inc.
Attn: Human Resources Department
1205 O'Neil Highway
Dunmore, PA 18512
ENROLLMENT
REPORTING ANALYST Reports to: Enrollment Director
Location: Dunmore, PA
Summary of Position: This position will provide essential planning and
analysis around performance metrics, recommend process improvements, identify
trends related to performance, and create internal and client communications
on all performance standards.
Principal Duties of Position:
Provide ongoing analysis on performance standards using productivity
volume indicators.
Perform gap analysis and prepare documentation indicating improvement
measures.
Provide operational and analytical support in the enrollment department
Own reporting requirements for the department
Own the requirements for metric reporting within the enrollment department
and maintain responsibility for working with department managers on
consistent report tracking.
Participate in various initiatives to define, analyze, and recommend
solutions to address current reporting processes.
Provide metrics and reports to track receipts through submission to
CMS
Education and Experience:
Minimum of 2+ years experience in enrollment, billing, or recon processing.
Previous experience with project management including assigning and
tracking deliverables.
Strong knowledge of Medicare regulations preferred.
Bachelor’s degree or equivalent years of experience required.
Other Skills and Abilities:
Minimum 3 years experience of operations and analysis or similar experience
preferred.
Must have strong quantitative abilities with experience in data gathering
and analysis
Ability to work in a fast paced environment
Strong knowledge of spreadsheet, database, and work processing programs.
Requires Microsoft Excel, Power Point, and word application expertise.
Microsoft Access a plus.
Must be able to work under pressure and take the initiative in order
to work efficiently within a team environment. Strong collaboration
and communications skills a must.
Be capable of independent problem solving.
Possess strong time management skills.
Must possess solid product knowledge and have excellent written,
verbal and presentation skills.
The incumbent must be capable of handling multiple tasks simultaneously
and must remain self confident and professional when representing TMG.
Must be detail oriented, able to interpret CMS regulations, self
directed and able to work with minimal supervisions.
The incumbent must also be able to work under pressure with strict
timeframes, have strong organizational and prioritization skills along
with a working knowledge of MS Word and Excel.
Interested applicants may click
here to attach resume or send resume with salary requirements to:
TMG Health, Inc.
Attn: Human Resources Department
1205 O'Neil Highway
Dunmore, PA 18512
Junior Financial Analyst Reports to: Performance Reporting Supervisor
Location: Dunmore, PA
Principal Duties of Position:
Analyze operational performance.
Prepare statistical reports and key performance indicators reports.
Design and prepare management reports.
Conduct ad hoc analysis.
Help on special client audits.
Help with the annual SAS 70 Type II work-papers and other internal operational Audits
Develop, evaluate and report on contract performance metrics to assess such performance relative to customer contract expectations and general performance standards as prescribed in the customer’s contract.
Help to establish and perform data integrity and validation tests of the on-going business in order to identify variances in a timely manner.
Ensure financial performance targets are met by analyzing operational performance and financial metrics.
Determine root cause of identified variances and support/ follow through to resolution.
Education and Experience:
BS Degree or equivalent
Accounting or business background while not mandatory would be desirable
2 to 5 year’s experience – health care experience a plus.
Other Skills and Abilities:
Excellent analytical skills.
Demonstration of project management skills.
Ability to handle multiple tasks.
Financial modeling skills.
Detail oriented.
Interested applicants may click
here to attach resume or send resume with salary requirements to:
TMG Health, Inc.
Attn: Human Resources Department
1205 O'Neil Highway
Dunmore, PA 18512
Member Publication Supervisor Reports to: Enrollment Manager (Infrastructure)
Summary of Position: This position is responsible for the direct oversight and training of the Enrollment Document Coordinators at TMG Health.
Principal Duties of Position:
Coordinate with Communication Specialist to develop and disseminate client communications related to the solicitation of new and revised enrollment letters and materials;
Liaison with Account Management and Enrollment Managers/Liaisons to obtain new and revised enrollment letters and materials;
Coordinate with Fulfillment to develop timelines and production plans for printing and/or fulfillment of member materials, including annual mailings;
Oversee and lead all activities related to TMG fulfillment of annual mailings (ANOC, EOC/LIS Rider, ID Card Reissues, etc) to ensure timely delivery to plan members;
Ensure mechanisms are in place for tracking all member material activities; communicate status of materials to the Operational areas;
Oversee maintenance of client letter matrix and dissemination of updates to internal customers;
Oversee activities related to development, testing, client signoff and installation of materials into production; ensure procedures are in place for appropriate documentation of these activities;
Assist the Operational areas with troubleshooting extract/letter file issues;
Monitor CMS guidance related to member materials; serve as the subject matter expert to clients;
Track and report status of letters and materials from initial receipt to production;
Develop, submit and track status of all Change Requests related to enrollment letters/materials;
Monitor Documentation Coordinator performance (production, quality and attendance). Provide feedback to the Coordinator. Utilize discretion when dealing with staff in the conduct of their work in order to decide proper courses of action when necessary. Report staff issues to management as necessary.
Education and Experience:
Demonstrated leadership skills in a business environment. Requires minimum 1 year experience in a Team Leader role. Prior supervisory experience strongly preferred. Minimum of 2-years of experience in enrollment processing. Additional Healthcare experience and strong knowledge of Medicare regulations are required. Communications, marketing or editorial background desired. College degree is required.
Incumbent must be proficient in Microsoft Outlook, Word and Excel. Experience with Microsoft Access preferred.
Other Skills and Abilities:
Must possess solid product knowledge, and have excellent written, verbal, and presentation skills. In addition, the incumbent must be capable of handling multiple tasks simultaneously, strong attention to detail, and must remain self confident and professional when representing TMG. Strong organizational skills are essential.
Ability to work scheduled hours. Overtime may be required including evenings, nights, weekends, and holidays.
Salary range on this position Exempt position
Interested applicants may click
here to attach resume or send resume with salary requirements to:
TMG Health, Inc.
Attn: Human Resources Department
1205 O'Neil Highway
Dunmore, PA 18512
PROGRAMMER ANALYST
I Reports to: Team Lead, DocProcessing
Location: Scranton, Pa
Summary of Position: This position, under minimal supervision, provides
broad and integrated applications and support for mission critical computing
on single/multi-user production system. The qualified candidate will be
able to analyze, design, develop and test standard applications as requested
by both internal and external customers.
Principal Duties of Position:
Works with limited specifications to meet programming assignment goals
and objectives in a timely and accurate manner
Codes, tests, debugs, documents and installs modified and new programs
Maintains integrity of program logic and works within the checks
and balances for operational controls
Provides the Team Leader with innovative and creative recommendations
for problem solving
Maintains an up-to-date knowledge of a broad range of computer technology
and standards
Education and Experience:
Two to four years college in related field and/or equivalent experience
Object Oriented Coding a must
Experience in SQL2003/2005 language
Experience in understanding and editing code written in Java Script,
XML and Visual Basic 6
Experience in understanding and editing code written in C# and .NET
a plus
Other Skills and Abilities:
Display analytical skills to be able to understand supplied specifications
Ability to communicate with all levels of staff and management
Interested applicants may click
here to attach resume or send resume with salary requirements to:
TMG Health, Inc.
Attn: Human Resources Department
1205 O'Neil Highway
Dunmore, PA 18512
PROGRAMMER ANALYST
II Reports to: Team Lead, DocProcessing
Location: Scranton, Pa
Summary of Position: This position, under minimal supervision, provides
broad and integrated applications and support for mission critical computing
on single/multi-user production system. The qualified candidate will be
able to analyze, design, develop and test standard applications as requested
by both internal and external customers.
Principal Duties of Position:
Work with limited specifications to meet programming assignment goals
and objectives in a timely and accurate manner
Code, test, debug, document and install modified and new programs
Maintain integrity of program logic and coding while working within
the checks and balances for operational controls
Provide the Team Leader with innovative and creative recommendations
for problem solving
Maintain and up-to-date knowledge of a broad range of computer technology
and standards
Education and Experience:
Four plus years college and two plus years experience in related filed
or five plus years equivalent experience
Object Oriented Coding a must
Experience programming in SQL 2003/2005 language
Experience writing and editing code written in Java Script, XML,
C# and PHP
Experience in understanding and editing code written in Visual Basic
6
Experience in understanding and editing code written in .NET and
VBScript a plus
Other Skills and Abilities:
Display analytical skills to be able to understand supplied specifications
Ability to communicate with all levels of staff and management
Interested applicants may click
here to attach resume or send resume with salary requirements to:
TMG Health, Inc.
Attn: Human Resources Department
1205 O'Neil Highway
Dunmore, PA 18512
SINGLE
MAINTENANCE UNIT PROCESSOR Reports to: Reconciliation Manager
Location: Dunmore, Pa
Summary of Position: This specialist position involves analyzing and
researching all discrepancies that are created due to transactions not
being processed correctly. The specialist needs to be able to understand
the reasons for this and to be able to correctly update the member’s
record on Facets and also be able to decide if the member needs to a retro
enrollment processed. The specialist also needs to determine what type
of retroactive adjustment needs to be completed, i.e. E-submission or
IG Submission. The main goal of the specialist is to correct the transaction
on Facets and have the member correctly submitted to CMS.
Principal Duties of Position:
Must have solid understanding of the Facets Enrollment System
Must possess solid understanding of how to understand and interpret
the CMS MARX system
Ability to use Microsoft Excel and Word applications
Ability to understand how CMS guidelines apply in the correction
process
Ability to understand complex transactions scenarios and make independent
decisions based on research performed in several different systems to
determine a plan of action for members
Ability to receive information from management and/or other departments
and be able to determine the proper use and functionality of the information
Must be able to research transactions and make independent decisions
on how to correct them and how to use the necessary tolls of the job
to help in making the correct decision
Ability to work in a group to accomplish team processing standards
set forth by management
Ability to shift between types of work quickly with very little transition
time
Must have a solid understanding of how to reprocess a transaction
(how to change a member record)
Required to follow detailed instructions and department guidelines,
as well as inform management of any improvements/adjustments that are
needed in the instructions or guidelines.
Able to complete assignments and take responsibility for department
involvement
Education and Experience:
6 plus months of detailed Facets or enrollment processing experience
Other Skills and Abilities:
Ability to read and interpret documents such as safety rules, operating
and maintenance instructions, and procedure manuals
Ability to write routine reports and correspondence
Ability to speak effectively before groups of customers or employees
of organization
Basic math skills
Ability to solve practical problems and deal with a variety of concrete
variables in situations where only limited standardization exists
Ability to interpret a variety of instructions furnished in written,
oral, diagram, or scheduled form
Interested applicants may click
here to attach resume or send resume with salary requirements to:
TMG Health, Inc.
Attn: Human Resources Department
1205 O'Neil Highway
Dunmore, PA 18512
Careers
