Manager, Benefit Eligibility

2 months ago

Halifax, Canada Province of Nova Scotia Full time

**Department**:Health and Wellness

**Location**:HALIFAX

**Type of Employment**:Term

**Union Status**:Exclusion - Non Union - NSPG

**Closing Date**:4/11/2023 (Applications are accepted until 11:59 PM Atlantic Time)

**About Us**:
The Department of Health and Wellness offers opportunities to grow and advance in a dynamic sector that touches the lives of all Nova Scotians. Along with our partners, including the Nova Scotia Health Authority and the IWK Health Centre, we’re committed to continually improving our health care system. With a focus on collaborative primary health care, improved supports for mental health and addictions, digital health, capital infrastructure, and more, the department is thinking differently about how to plan, fund, legislate and monitor to improve access and service delivery. To do this, we need leaders at all levels of the organization who embrace a challenge and believe in their ability to make a difference.

**About Our Opportunity**:
Under the direction of the Director, Benefit Eligibility the Manager is responsible for timely and accurate processing of all interprovincial hospital reciprocal billing programs. Is responsible for all out-of-country/province transactions related to medical treatment not available within Nova Scotia for eligible residents, working with MSI and DHW Medical Consultants and to coordinate, process all out of country emergency medical claims for NS residents. Is accountable to manage all activity related to Nova Scotia health card registration, eligibility and renewals. Is accountable for preparation, reconciliation and explanation of all budget and forecast activity, including the integrity and analysis of all financial statements for the Benefit Eligibility section. Responsible to have working knowledge and understanding of national IHIACC and RRWG activities, including the development and management of hospital reciprocal billing rules and to ensure the annual reciprocal billing rates provide reasonable compensation for services provided and are supported by easily understood calculations. This requires ongoing interaction, involvement with staff from DHW MIS and the financial staff from NSH and IWK. Accountable to draft and finalize responses to all ministerial inquires for the section and to fill-in and cover the role of Director, Benefit Eligibility in his absence.

**Primary Accountabilities**:
This position will be responsible for, but not limited to:

- Ensures the effective management of human and financial resources by setting and evaluating staff performance targets, promoting diversity and a healthy, respectful workplace, demonstrating the leadership competencies, respecting corporate human resources practices, promoting teamwork and individual development, maintaining internal communication, monitoring revenues and expenditures, adhering to procurement guidelines, acquiring goods and services in the most cost effective manner, and participates in budget forecasting for the fiscal year.
- Assists in the development of policy and programs, implementation and administration of health card eligibility and registration, and privacy matters through the Director, Benefit Eligibility, the Senior Executive Director, EHS, Benefit Programs and Eligibility and to the Deputy and/or Health Minister for government approval.
- Assists in the oversight of the Medavie Blue Cross contract to ensure service levels are maintained or exceeded to deliver a consistently high-quality customer service. Also assists in developing strategies to improve health card eligibility services, determining & recommending appropriate resolutions to the Director for final approval.
- Oversees the accurate processing of hospital reciprocal claims and out of country emergency and referral claims within the parameters of national reciprocal agreements, IHIACC guidelines and DHW policy.
- Provides ongoing interaction and direction to the Financial Services Officer 2 (FSO 2) to ensure appropriate monitoring of revenue and expenditures of reciprocal billing, adhering to procurement guidelines, acquiring products and services in the most cost effective manner, and participating in forecasting the annual budget requirements.
- Acts on behalf of the Director in his absence, ensuring consistent program performance, issue identification and resolution.
- Participates on the national Rate Review Working Group (RRWG), which supports the Interprovincial Health Insurance Agreements Coordinating Committee (IHIACC) and involves detailed/sensitive conversations with national counterparts to make sure Nova Scotia is able to bill services provided at appropriate rates to recover costs for services provided to Canadian citizens with an active health card. Incumbent must ensure timely submissions of Nova Scotia rate information for review seeking RRWG approval. Ensures the calculations are understood and supported by CIHI.
- Implements new programs involving the Insured Services section.

**Qu

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