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As a Provider Relations Representative, you will provide education and training support for network providers, staff, suppliers, physicians, beneficiaries, and referral agents. Develop and produce training and educational materials, conduct workshops, and support relationships with various stakeholders.
Responsible for analysis, design, programming, and implementation of complex applications tasks and projects. Provide technical direction and support in the development and maintenance of business systems software. Develop enterprise-level applications and custom integration solutions. Lead and coordinate complex projects or phases of large projects.
The Database Analyst II is responsible for analyzing, developing, and maintaining complex database designs and data models, ensuring adherence to standards, monitoring and troubleshooting databases, and mentoring junior staff. The role involves defining data architecture, recommending best practices, and analyzing database software upgrades.
Analyze data for creation of statistical reports used for program or process evaluation. Responsible for maintaining databases, extracting data for analysis, and running and reviewing reports to support operational functions.
Provides administrative support to payroll, benefits, leave of absence, and the HR support center. Responsible for indexing/scanning of all payroll documents.
Under general supervision, analyzes policies, procedures, and reports, recommends operational improvements, conducts workflow audits, generates data for reports, maintains databases, and communicates with management.
Develops and provides training and education for network providers, staff, and beneficiaries. Produces training materials, conducts workshops, and facilitates meetings. Acts as a liaison between various groups and ensures educational needs are met. Requires 4 years of experience in customer service, claims processing, education/training, or healthcare. Bachelor's degree or equivalent work experience.
Monitor/implement quality improvement/management activities, conduct medical reviews, analyze findings, make recommendations for corrective actions, and prepare formal documentation for compliance. Perform HEDIS data collection and NCQA accreditation activities.
As an intern, you will support various business unit tasks, participate in training, assist with operational activities, conduct research and analysis, and communicate with team members to learn about company operations.
Perform quality control audits to evaluate the accuracy and effectiveness of departmental operations functions, including claims, membership, customer service/call center, workflow, processing support systems, procedures, documentation, etc. Identify problems, analyze cause and effect, and make recommendations for improvements.
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