Strong analytical and problem-solving skills for process improvement.
Excellent organizational skills with the ability to manage multiple projects.
Outstanding verbal, written, and interpersonal communication skills.
Proficient in Microsoft Office Suite.
Ability to foster effective working relationships.
Responsibilities
Identify and analyze operational data to support business objectives.
Develop and enhance workflows and processes to improve customer service.
Analyze business problems and recommend effective solutions.
Lead project development and implementation to achieve desired outcomes.
Document and communicate project milestones and results clearly.
Assist in implementing standard policies and procedures for compliance.
Participate in systems testing and recommend process improvements.
Provide support and training to internal departments and external entities.
Benefits
Opportunities for professional development and training.
Supportive work environment fostering collaboration.
Access to resources for continuous improvement initiatives.
Full Job Description
Job Description
Responsible for leading the development and implementation of programs and strategies by identifying insights that enhance business decision making capability. This includes developing or changing workflows and implementing process improvements to enhance organizational products, programs and service to our customers.
Identify and analyze operational data and develop insights in support of business objectives.
Develop and improve work flows and business processes within defined areas to improve customer service, decrease operational costs and improve overall quality.
Identify and/or analyze business problems and develop recommendations for solutions to problems.
Lead the development and implementation of projects and/or teams in order to produce desired results.
Document and communicate project concepts, milestones and results.
Recommend and assist with implementing standard policies and procedures.
Ensure that corporate compliance is communicated, implemented and monitored on an ongoing basis.
Participate in systems testing, develop procedures/controls and provide recommendations for the ongoing improvement of the updated process.
Provide support to internal departments and external entities by answering questions, supplying information and training.
Create and present reports and presentations to display operational data and proposed business changes.
Qualifications
Bachelor's Degree in a related field is preferred.
Four (4) years of experience in a related field is required.
Excellent analytical and problem-solving skills to identify, evaluate, recommend and implement changes to processes or procedures to address problems and improve departmental effectiveness.
Organizational skills and ability to prioritize; must be able to lead multiple activities with varying timelines.
Excellent verbal, written communication and interpersonal skills.
Ability to lead and contribute to business unit and/or corporate projects.
Proficient in Microsoft Office Suites.
Ability to develop and maintain effective working relationships.
Department Preferences
Proven experience processing Facets BCNA claims across Facility, Professional, and Home lines of business.
Understanding of Medicare Advantage plan structure and CMS regulations & guidance.
