Independent Health

Analyst

• Develop, deploy, and maintain role-based logical access processes
• Guide all components of the enterprise approach to critical security functions such as: identity and access management (IAM), privileged identity management, and access controls
• Develop, implement and maintain logical access roles within the SailPoint IdentityNow platform to ensure access is provisioned/deprovisioned at the appropriate times to ensure compliance with corporate policies
• Manage the oversight and maturation of efficiencies in the security functions ensuring adherence to company policy and standards
• Provide governance within the information risk office team and others with regard to the access management and privileged identity management arenas
• Develop, foster, and mature process efficiencies with the goal of reducing time and effort to perform
• Maintain security policies including updates to reflect changing practices and business needs
• Monitor compliance with policies
• Monitor and audit user permissions within applications
• Assist with all user audit activity and fulfillment of internal and external audit requests
• Establish processes to monitor and analyze user and privilege identity access and maintain separation of duties (SoD)
• Develop and maintain process and control documentation supporting IAM services
• Develop training materials related to IAM processes and technologies
• Consult with key business stakeholders to evaluate functional requirements and translate those requirements into information security solutions
• Provide guidance to business partners about applicability of information security to meet business needs
• Support the documentation and accreditation processes necessary to ensure that new IT systems meet the organization's information security requirements
• Respond to crisis or urgent situations to mitigate immediate and potential threats
• Investigate and analyze all relevant response activities
• Represent Information Risk Office in cross-functional meetings and projects
• Develop, foster, and mature process efficiencies with the goal of reducing time and effort to perform
• Participate in the execution of enterprise-wide information security program

Identity and Access Management Analyst

Billing Specialist

• Completing the billing of pharmacy and medical claims
• Act as a liaison between patients and insurance companies
• Ensure billing accuracy and compliance with CMS guidelines
• Process and set up deliveries to medical offices

Compliance

• Manage and monitor compliance activities related to PBD’s accreditations, certifications, licenses, and regulatory requirements
• Ensure policies, procedures, and reporting align with compliance standards
• Interpret and advise on accreditation and regulatory requirements
• Review documentation for audit readiness and compliance
• Serve as a liaison with accreditation bodies and coordinate validation reviews
• Support regulatory audits, market conduct exams, and compliance submissions
• Facilitate meetings, dashboards, and oversight activities with leadership and committees
• Manage policy and procedure processes and timelines
• Coordinate STAR measures, corrective actions, and privacy/security events

Senior Compliance Specialist

Manager

• Managing behavioral health benefits through the administration of quality improvement functions
• Develop a plan of care based upon providers of care clinical assessments and patients
• Identify eligible insured individuals from available data set(s)
• Conduct assessments to identify individual needs and develop person centered care plans
• Monitor and evaluate effectiveness of care plan and modify plan as needed
• Coordinate with internal and external resources to meet identified needs of the members
• Collaborate with other departments for specific BH related case review, product/benefit development, claims, servicing and network as directed
• Assist with the preparation of the annual program evaluations and Work Plans for the BH CM Programs

Behavioral Health Case Manager

• Responsible for billing all claims (pharmacy and medical)
• Managing rejections to ensure appropriate follow up and delivery promise times are met
• Act as a liaison between patients and insurance companies
• Work with payors to resolve any billing issues
• Process and set up deliveries to medical offices
• Confirm financial aspects of the claims
• Assist the Patient Care Specialists in workflow and with incoming and outgoing calls

Actuary

• Provide a full scope of actuarial and statistical analyses
• Support both internal and external customers
• Collaborate with other team members and business units
• Support the budget development process including forecasting
• Communicate with external departments to support budget preparation
• Provide analysis and reporting for financial and regulatory requirements
• Perform actuarial analysis and modeling including reserves, pricing, and forecasting
• Develop ad hoc reports through query building and data extraction
• Propose and assist in development of process improvements

Senior Actuarial Analyst – PT

Human Resources

• Coordinate new employee onboarding including being a main point of contact to the new hire, confirming drug/background check requirements are completed and system credentials are obtained
• Assist Talent Acquisition team with various activities as needed including high volume recruitment, community outreach, phone screens, interview events, and job fairs
• Coordinate all required regulatory compliance for new hires including the I-9 and wage theft processes, enrollments in required training modules and follow up of incomplete trainings
• Coordinate the hiring of contingent workers (temps, contractors, and interns) and enroll them into appropriate online trainings
• Maintain accurate HR data in multiple systems for all new hires/job changes and follow up as needed
• Provide excellent customer service by handling incoming requests and questions from associates and candidates
• Create and coordinate associate and new hire communications
• Provide additional department support as needed (purchasing supplies/catering, processing invoices)

HR Coordinator

Customer Support

• Display confidence and passion for service when connecting with members
• Actively listen and assess needs
• Utilize system tools and resources to address inquiries
• Make appropriate process or regulatory determinations
• Research complex issues pertaining to benefits, claims, plans, and eligibility

Customer Service Representative

Product Manager

• Responsible for development and/or maintenance for the life cycle of Medicare products
• Continuously assess market needs, future technology, competitor products/services and regulatory environment
• Synthesize data from various sources to monitor product performance
• Provide product updates and ensure informed decisions
• Act as a liaison among functional areas and externally for product-related issues

Identity and Access Management Analyst

Billing Specialist

Senior Compliance Specialist

Behavioral Health Case Manager

Billing Specialist

Senior Actuarial Analyst – PT

HR Coordinator

Customer Service Representative

Product Manager – Medicare