About The Position

This role serves as a subject matter expert for Provider Operations on major department and corporate initiatives, projects, process improvements, or other significant activities. The individual will independently ensure Provider Operations' needs are met, clearly articulate business requirements, and escalate concerns to management. Responsibilities include conducting data analysis for projects and operational activities, analyzing trends to identify root causes and develop recommendations, and documenting analysis and executing solutions. The role also involves direct communication with providers to resolve complex inquiries and proactively identifying and analyzing issues that could negatively impact the department and the company.

Requirements

  • Bachelor's degree and 2 years of related experience, or equivalent combination of education and experience
  • Basic working knowledge of Microsoft Office applications, including but not limited to Word, Excel, and Outlook.
  • Strong oral and written communication, listening and presentation skills.
  • Strong organizational skills for tracking and handling multiple projects with deadlines.

Responsibilities

  • Serve as Provider Operations subject matter expert on major department and corporate initiatives, projects, process improvement or any other major activity as assigned by management independently.
  • Independently ensure Provider Operations' needs are addressed; clearly articulate business needs so that the department is not negatively affected and elevate concerns and issues to management when applicable. Pursue issues until a satisfactory resolution is reached.
  • Independently conduct data analysis related to major projects and operational activities, including designing analysis, gathering and analyzing data, analyzing trending information to identify root causes and develop recommendations for resolution, prevention procedures and processes, and constructing documentation analysis and executing solutions as directed by management.
  • Work directly with providers both through writing and over the phone to resolve complex inquiries.
  • Proactively identify, research, and conduct analyses to resolve issues and trends that might negatively impact the department and HMSA as a whole.
  • Performs all other miscellaneous responsibilities and duties as assigned or directed.
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