About the role
- Responsible accurate benefit and product implementations, adjudication and payment of claims.
- Conduct data analysis and present insights with internal stakeholders to understand opportunities to improve.
- Support internal department and corporate projects.
- Manage network design projects.
- Maintain accurate and timely processing of claims and reject management.
- Lead for JIRA enhancements.
- Provide and lead implementation of projects or clients as needed.
- Provide on-going formal training to team members.
- Manage projects cross-functionally as needed.
- Ability to vendor and/or client-face as needed.
- Participate in, adhere to and support compliance and diversity, equity, and inclusion program objectives.
- Other duties as assigned.
Requirements
- Bachelor's degree in business, marketing, or related area preferred.
- 5 years of analyst experience required.
- 5+ years in health care related operations roles required.
- Knowledge of PBM operations and industry preferred.
- PC skills; Microsoft Office, Email, and Internet.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
data analysisclaims adjudicationclaims processingproject managementnetwork designJIRA enhancementsvendor managementclient managementformal trainingcompliance
Soft skills
leadershipcommunicationcollaborationorganizational skillsinterpersonal skills