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Associate Health Plan Operations Jobs

Health Plan Operations Associate
By Firefly Health At Watertown, MA, United States
Have successfully proven remote-work time management skills
Assist members with questions regarding the Firefly Health Plan; Provider network, medications, prior authorizations, and Care-Pass requirements
Furnish benefits, claim status, eligibility checks, etc. to Providers on an Inbound and Outbound call basis.
Execute courteous, accurate, and prompt follow-up with customers by utilizing worklists to successfully manage daily tasks
Have excellent communication skills and love delivering great service to people, often at stressful moments in their health journey
Have experience using digital technology to improve service delivery
Health Plan Liaison (Hybrid)
By Better Health Group At Tampa, FL, United States
Excellent organizational, time-management, and multi-tasking skills with strong attention to detail
Demonstrate ability to manage time and organize meetings effectively
Demonstrate knowledge of Health Plan specific policies, procedures, and resources
All action items are completed by the due dates set forth by the Health Plan and Manager of Core Operations
At least 3 years of experience in a healthcare-related environment
Demonstrated resourcefulness, initiative, and results-oriented capabilities
Health Plan Liaison Manager (Hybrid)
By Better Health Group At Tampa, FL, United States
Excellent organizational, time-management, and multi-tasking skills with strong attention to detail
Maintain tasks in the project management system to reflect any updates or changes to Core Operations processes
Review tasks for accuracy that require manual data entry
Demonstrated resourcefulness, initiative, and results-oriented capabilities
Excellent written and verbal communication skills.
Are you looking for a career opportunity that will help you grow personally and professionally?
Vp, Health Plan Sales
By RxSense At , Boston
Report sales activity to management as required.
Perform or assist with any operations, as required to maintain workflow and to meet schedules and quality requirements.
Bachelor's degree or multiple years of Technology or PBM equivalent/relevant experience is required.
Interaction with key influencers as needed which may include Brokers/Consultants as directed.
Participate in and perform analysis of opportunities, potential client needs and objectives that fit corporate goals and objectives.
Delivery of Corporate Business Model and Value Proposition to prospects via phone call, email, conferences, speaking engagements, demos, and presentations.
Manager, Health Plan Delivery Services
By Availity, LLC. At ,
Managing, assigning, and prioritizing Health Plan implementation related project and program management activities through the implementation lifecycle
Identifying the roles, skills, and knowledge required and ensure staff has the resources and skills needed to support all work initiatives
Interested in furthering your education? We offer education reimbursement!
Bachelor’s degree or the equivalent in work experience
Minimum of 5 years of healthcare and/or IT related project implementations experience
Experience in interviewing and hiring practices
Client Success Associate - Health Plan
By Included Health At United States
Advanced computer and analytic skills, including experience creating client presentations that tell a compelling story of value delivered
3-5 years of experience of demonstrated success in account-based marketing, sales, Client Success or health care administration and benefits
Manage inbox for client inquiries, coordinating across internal departments to find answers and deliver superior client service
Develop and deliver regular reports for clients, and provide client education as needed
Excellent interpersonal, presentation, and persuasion skills with the ability to diplomatically navigate the complexity of client relationships
Superior customer service skills with the ability to articulate and respond to highly complex issues
Vp Or Dir Of Health Plan Operations
By myPlace Health At Los Angeles, CA, United States
Manage enrollment data and data systems including data transfers and the development and management of systems to meet PACE programmatic requirements
Manage and provide oversight to our TPA, PBM, pharmacy services, and other key vendors, including claims management, issue resolution, and receivables/payables
Experience in corporate finance, venture-backed startups, private equity, investment banking, or other finance-focused roles in high-growth and entrepreneurial environments
Prior experience building from the ground up or scaling a Finance & Accounting function at a high-growth healthcare organization preferred
Los Angeles preferred; relocation benefits offered if willing to reside in the Los Angeles metro area
Develop policies and procedures that meet applicable PACE program requirements
Health & Welfare Plan Delivery Lead
By GE HealthCare At Schenectady, NY, United States

Job Description Summary In this role, you will be responsible for the overseeing the delivery of Health and Welfare benefits to GE HealthCare participants, ensuring they are properly ...

Financial Operations Associate, Engagement Health, Remote
By Huron At Chicago, IL, United States
Manage the client Net Promoter Score (NPS) survey process, and administer the survey within Salesforce for all applicable projects
Create and maintain a system of organization to oversee Engagement Health program usage and compliance across all Healthcare projects
Create and maintain monthly Engagement Health reporting
Assist in development of operational and executive-level Engagement Health dashboards
Review project outcomes to identify and escalate trends that can be used to improve future project outcomes
Perform training on program best practices to ensure positive compliance and results
Vp, Health Plan Systems
By Health Partners Plans At Philadelphia, PA, United States
Benefits & Wellness Program including generous Time Off
Develop and manage technology budgets for the health plan, ensuring that resources are allocated effectively to meet the organization's needs.
Excellent leadership, interpersonal, and communication skills.
Ability to effectively manage budgets and resources to meet the needs of the organization
Strong problem-solving skills and the ability to think creatively to solve complex technical problems.
Competitive Compensation Packages, including 401(k) Savings Plan with Company Match and Profit Sharing
Plan Document Associate - Remote
By Trustmark At United States
1 year of experience in the healthcare industry
Detail oriented, organized and strong analytical skills
Works closely with internal and/or external customers to prepare Summary Plan Descriptions and/or group policies.
Prepares amendments/booklet certificates, as appropriate for clients with less complex cases and/or less than 100 lives.
Prepares and distributes group specific documents.
Other duties as needed or assigned.
Senior Manager, Health Plan Partnerships
By Maven Clinic At New York, NY, United States
Experience working with health plans, benefits consultants, benefits administrator and/or pharmacy benefit managers a plus
7+ years of experience, with a strong background in healthcare and/or benefits
Drive productive client meetings while proactively anticipating client needs and milestones specific to the employer benefits and health plan industry
Demonstrated ability to manage complex cross-functional projects
Experience building and improving processes for high growth company
Excellent oral and written communications skills; expert listening skills
Health Plan Analyst - Student Position
By Healthee At New York, NY, United States
Developing various reports, presentations and summarizing key findings from data analysis and communicating them to the management team.
Strong analytical skills and proficiency in data analysis tools
Excellent written and verbal communication skills, with the ability to present complex information in a clear and concise manner.
Detail-oriented with the ability to manage multiple tasks and prioritize effectively.
The job is 100% remote (it may be required to arrive to the Tel Aviv office as needed).
Compiling, organizing and analyzing health plan data to assist in delivering essential health plan information to users
Vp Or Dir Of Health Plan Operations
By myPlace Health At United States
Manage enrollment data and data systems including data transfers and the development and management of systems to meet PACE programmatic requirements
Manage and provide oversight to our TPA, PBM, pharmacy services, and other key vendors, including claims management, issue resolution, and receivables/payables
Experience in corporate finance, venture-backed startups, private equity, investment banking, or other finance-focused roles in high-growth and entrepreneurial environments
Prior experience building from the ground up or scaling a Finance & Accounting function at a high-growth healthcare organization preferred
Los Angeles preferred; relocation benefits offered if willing to reside in the Los Angeles metro area
Develop policies and procedures that meet applicable PACE program requirements
Federal Health Plan Specialists - National Remote ($67800.00 - $133100.00 / Year)
By Talentify.io At United States
Manage special projects on an as needed basis.
Associate Degree (or higher) OR experience working with FEHB plans
3+ years of customer service experience
Exceptional public speaking skills - must demonstrate a history of public speaking to small and large audiences
Strong verbal and written communication skills.
Physical Requirements And Work Environment
Credentialing Specialist - The Health Plan
By Texas Children's Hospital At Greater Houston, United States
A minimum of three (3) years of managed care or health care experience
Group process and problem solving is helpful
Reviews and understands the internal policies & procedures for performing credentialing and
Re-credentialing primary source verification and file and report preparations for committee
Establishes individual files for each applicant containing the application, documents to support primary source verification and any other communications
Contacts providers to request updates to licenses and documents with expiration dates
Health & Welfare Plan Delivery Lead
By GE HealthCare At Illinois, United States

Job Description Summary In this role, you will be responsible for the overseeing the delivery of Health and Welfare benefits to GE HealthCare participants, ensuring they are properly ...

Vp, Health Plan Operations (Remote In Indiana)
By Molina Healthcare At , Indianapolis, 46240, In

To all current Molina employees:

Project Coordinator (Health Plan Operations)
By Better Health Group At Tampa, FL, United States
Excellent organizational, time-management, and multi-tasking skills with strong attention to detail
Attend and participate in Core Operations team meetings, 1:1 meetings with Manager of Core Operations, and interdepartmental market meetings as required
At least 3 years of experience in a healthcare-related environment
Demonstrated resourcefulness, initiative, and results-oriented capabilities
Excellent written and verbal communication skills.
Are you looking for a career opportunity that will help you grow personally and professionally?
Student Health Insurance Plan Billing Manager
By Wellfleet At United States
Experience in health insurance billing preferred.
Advanced Microsoft Office skills, specifically Excel and Access.
Coordinate billing and collections efforts for Wellfleet Student Health Insurance Plan (SHIP) business.
Create invoices and statements of account for SHIP customers using data from the enrollment system.
Create and maintain premium accounts receivable summaries and documentation and reconcile to general ledger.
Organize and lead frequent inter-departmental meetings and communications regarding specific details and action plans for individual accounts.