Supports the implementation and/or drives the ongoing operational maintenance of assigned product(s) or service area(s)
Identifies opportunities for integrated process improvement
Creates and maintains reporting tools to effectively analyze and develop process improvement opportunities
Serves as the subject matter expert (SME) for the assigned product(s) or service area(s)
Monitors assigned internal/external relationships to ensure compliance with contractual requirements
Develops effective relationships with key partners and stakeholders to influence and drive operational enhancements
Creates reports and supports business review presentations to key stakeholders
Manages projects including the implementations for delegated functions as needed
Requirements
A Bachelor's Degree in business administration / related field
2+ years of experience in Leading or supporting projects in Benefits, Product Management, Marketing and Sales, Strategic Planning, and/or Project Management –OR- Data analysis and process improvement in Benefits, Healthcare or Regulatory/Government Affairs -OR- Vendor management or oversight; preferably with healthcare vendors
2+ years of experience in customer service experience in a healthcare contact center or customer service environment dealing with claims, grievances pharmacy and appeals authorizations in one or more of the following: Medicare, Medicaid, PDP, Exchange etc.
Other Experience in health care or managed care environment (preferred)
Other Experience working the state reporting, regulatory/government affairs (preferred)
Benefits
competitive pay
health insurance
401K and stock purchase plans
tuition reimbursement
paid time off plus holidays
flexible approach to work with remote, hybrid, field or office work schedules
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
data analysisprocess improvementproject managementreporting toolsvendor management