Health Plan Quality Control Associate

Collective Health•Lehi, UT

3d•$22 - $27•Hybrid

About The Position

At Collective Health, we’re transforming how employers and their people engage with their health benefits by seamlessly integrating cutting-edge technology, compassionate service, and world-class user experience design. As part of the Group Administration team within Health Plan Operations, the Plan Operations team owns specialized processes that require close collaboration with finance, legal, product, and other internal teams. The Plan Operations -- Plan Structure, Launch & Design team (PSL&D) will be responsible for owning and further developing key processes that support and enable the Member Claims team and successful client implementations. PSL&D owns, builds, and maintains Collective Health’s core business logic and system while implementing our clients’ healthcare plans onto the Collective Health platform.

Requirements

Healthcare industry experience and coding knowledge base
To be self-motivated, intellectually curious, and take ownership for everything you do
To have Excellent Microsoft Office and/or Google Suites skills, particularly in Excel / gSheets and PowerPoint / Slides
To have strong analytical thinking and problem-solving skills to collect, organize, analyze, and disseminate information with extreme attention to detail and accuracy
To be CPC or CCS certified or have worked in the healthcare industry for at least 1 year
To think critically and are willing to question the status quo in a constructive and thoughtful manner
To enjoy adding structure & taking a methodical approach to problems
To be a committed team player
To thrive on change and are enthusiastic about being along for the ride and learning from our experiences together
To possess a passion for Collective Health’s mission to transform the health insurance experience for employers and their employees
To be hyper attentive to details and processes

Responsibilities

Provide subject matter expertise for all quality control activities and provide required training to maintain quality policies and procedures related to the Plans Platform ecosystem.
Perform regular quality control activities and necessary updates on Plans Platform to ensure all benefit categories, CPT codes, etc. are current.
Collaborate with Health Plan Benefits Associates to ensure accurate artifact generation (SBCs, SPDs, OE takeaways, network benefit grids, portals)
Maintain robust quality assurance protocols throughout the implementation process for new and renewal clients.
Support new and existing team members by holding training meetings and attending office hours to ensure quality standards are understood and upheld
Own complex and/or high priority benefit builds and modifications for new and existing benefits
Assist in managing and supporting the end-to-end implementation process for new and renewal clients.
Apply a scalability lens to several key areas in Plan Operations -- plan stack, plan testing, data gathering workflows, plan design and analytics inquiries, and more including:
Working with software engineers to build internal tools to improve processes
Collaborate cross-functionally with Member Claims, Product, Development, Legal, Clinical, Copy, and Client Success teams to delight our customers