-
BCBS HMO Coordinator
3 weeks ago
Duly Health and Care Downers Grove, United States Full timeOverview · : At Duly Health and Care, we're dedicated to revolutionizing healthcare delivery through innovative solutions and collaborative partnerships. As a leading provider in the industry, we strive to empower individuals and communities to achieve optimal health outcomes. Jo ...
-
Payroll Administrator
3 weeks ago
Illinois State Toll Highway Authority Downers Grove, United StatesSalary: $80,000.00 Annually · Location : 60515, IL · Job Type: Professionals · Job Number: · Department: Office of Finance · Division: Payroll · Opening Date: 04/30/2024 · Closing Date: 5/21/2024 11:59 PM Central · Is this a union role?: No · Union Name: Salaried - 6 · Position ...
-
Illinois State Toll Highway Authority Downers Grove, United StatesSalary: Depends on Qualifications · Location : Central Support Complex 3460 Finley Road Downers Grove, IL · Job Type: Administrative Support · Job Number: · Department: FACILITIES AND FLEET OPS · Opening Date: 05/09/2024 · Closing Date: 5/22/2024 11:59 PM Central · Is this ...
-
Advocate Aurora Health Westmont, IL, United StatesAdvocate Aurora Health is seeking a Registered Nurse (RN) Home Health for a nursing job in Westmont, Illinois. · Job Description & Requirements · Specialty: Home Health · Discipline: RN · Duration: Ongoing · 40 hours per week · Shift: days · Employment Type: Staff · ...
-
Food Runner
3 weeks ago
Doughboy Restaurant Group Oak Brook, United StatesLa Barra · Rich Labriola, the visionary behind Doughboy Restaurant Group, including Labriola Chicago, Labriola Oak Brook, and Stan's Donuts, is embarking on an exciting journey of expansion and refinement in the hospitality industry. With new concepts on the horizon and a commit ...
-
Ocean FCL Import Specialist
4 weeks ago
Clutch Global Logistics, Inc. Lombard, United StatesJob Type: Full-Time (No Travel Required) · Company: Clutch Global Logistics, Inc. · Work Location: Hybrid (Partially Remote & Partially at 555 Waters Edge Suite 150 Lombard, IL 60148) · Basic Overview of Role and Responsibilities: · The successful candidate will assume responsibi ...
-
US-Canada Cross Border Trucking Specialist
4 weeks ago
Clutch Global Logistics, Inc. Lombard, United StatesJob Type: Full-Time · Company: Clutch Global Logistics, Inc. · Work Location: BLENDED: Mostly virtual with 1-2 days in the office at 555 Waters Edge Lombard, IL 60148 · Basic Overview of Role and Responsibilities: · The successful candidate will assume responsibility for the belo ...
-
Account Coordinator
4 weeks ago
Forum Financial Management, LP Lombard, United StatesAccount Coordinator and Billing Specialist · Forum Financial Management, LP · Forum Financial Management, LP is a rapidly growing Registered Investment Advisory Firm with more than $8.5 billion in assets under management. Forum was founded in 2002 and became an independent advis ...
-
Host
2 days ago
Doughboy Restaurant Group Oak Brook, United StatesLa Barra · Rich Labriola, the visionary behind Doughboy Restaurant Group, including Labriola Chicago, Labriola Oak Brook, and Stan's Donuts, is embarking on an exciting journey of expansion and refinement in the hospitality industry. With new concepts on the horizon and a commitm ...
-
Head Bartender
1 day ago
Doughboy Restaurant Group Oak Brook, United StatesJob Description · Job DescriptionLabarra · Rich Labriola, the visionary behind Doughboy Restaurant Group, including Labriola Chicago, Labriola Oak Brook, and Stan's Donuts, is embarking on an exciting journey of expansion and refinement in the hospitality industry. With new conce ...
-
Service Manager
3 weeks ago
Doughboy Restaurant Group Oak Brook, United StatesJob Description · Job DescriptionRich Labriola, the visionary behind Doughboy Restaurant Group, including Labriola Chicago, Labriola Oak Brook, and Stan's Donuts, is embarking on an exciting journey of expansion and refinement in the hospitality industry. With new concepts on the ...
-
Administrative Assistant
2 weeks ago
Innovista Health Oak Brook, United StatesJob Description · Job DescriptionDescription:Are you searching for a fulfilling role that can make a significant difference in healthcare? · At Innovista, we're devoted to driving transformative change in this essential sector. Our independent physician partners achieve exceptio ...
-
Home Care Liaison Registry
1 week ago
Advocate Health Oak Brook, United StatesHOME CARE LIAISON LOCATION: NORTH REGION HOSPITALS HOURS: DAYS REGISTRY WITH ROTATION TO WKDS AND HOLIDAYS Major Responsibilities:Responsible for the screening and accurate completion of referrals to ensure patients meet agency admission criteria and comply with state and federal ...
-
Manager of Strategic Operations
3 weeks ago
Innovista Health Oak Brook, United StatesJob Description · Job DescriptionDescription:Are you searching for a fulfilling role that can make a significant difference in healthcare? · At Innovista, we're devoted to driving transformative change in this essential sector. Our independent physician partners achieve exceptio ...
-
Advocate Aurora Health Oak Brook, IL, United StatesAdvocate Aurora Health is seeking a Registered Nurse (RN) Home Health for a nursing job in Oak Brook, Illinois. · Job Description & Requirements · Specialty: Home Health · Discipline: RN · Duration: Ongoing · 40 hours per week · Shift: days · Employment Type: Staff · REGISTERED N ...
-
Chief Of Staff
2 weeks ago
Forum Financial Management Lombard, United StatesJob Description · Job DescriptionChief of Staff · Forum Financial Management, LP · WWW.FORUMFINANCIAL.COM · Forum Financial Management, LP is a rapidly growing Registered Investment Advisory Firm (RIA) that has over 7 billion AUM. Forum was founded in 2005, and became an indepen ...
-
Chief Of Staff
1 week ago
Forum Financial Management, LP Lombard, United StatesChief of Staff · Forum Financial Management, LP · Forum Financial Management, LP is a rapidly growing Registered Investment Advisory Firm (RIA) that has over 7 billion AUM.Forum was founded in 2005, and became an independent RIA in 2009. At Forum, we use a highly diversified inve ...
-
Ocean FCL Import Specialist
1 week ago
Clutch Global Logistics, Inc. Lombard, United StatesJob Description · Job DescriptionJob Type: Full-Time (No Travel Required) · Company: Clutch Global Logistics, Inc. · Work Location: Hybrid (Partially Remote & Partially at 555 Waters Edge Suite 150 Lombard, IL 60148) · Basic Overview of Role and Responsibilities: · The successful ...
-
Ocean FCL Import Specialist
2 weeks ago
Clutch Global Logistics, Inc. Lombard, United StatesJob Type: Full-Time (No Travel Required) · Company: Clutch Global Logistics, Inc. · Work Location: Hybrid (Partially Remote & Partially at 555 Waters Edge Suite 150 Lombard, IL · Basic Overview of Role and Responsibilities: · The successful candidate will assume responsibilit ...
-
Chief Of Staff
1 week ago
Forum Financial Management, LP Lombard, United StatesChief of Staff · Forum Financial Management, LP · WWW.FORUMFINANCIAL.COM · Forum Financial Management, LP is a rapidly growing Registered Investment Advisory Firm (RIA) that has over 7 billion AUM. Forum was founded in 2005, and became an independent RIA in 2009. At Forum, we ...
BCBS HMO Coordinator - Downers Grove, Illinois, United States - Duly Health and Care
Description
Overview:
Job Title:
BCBS HMO Coordinator
Location:
Flexible (Remote options available)
Company
Overview:
At Duly Health and Care, we're dedicated to revolutionizing healthcare delivery through innovative solutions and collaborative partnerships. As a leading provider in the industry, we strive to empower individuals and communities to achieve optimal health outcomes. Join us in our mission to make a meaningful difference in the lives of millions.
We are seeking a dynamic and detail-oriented BCBS HMO Coordinator to join our Payor Contracting/MA Management team.
In this role, you will serve as the linchpin between our HMO Payor Contracting division and internal Duly operations areas.
Your expertise and proactive approach will be instrumental in fostering seamless communication, resolving issues, and optimizing operational efficiency.Responsibilities:
Key
Responsibilities:
Act as the primary liaison between payors and internal Duly operations, ensuring effective communication and collaboration.
Coordinate responses to payor issues under the guidance of the Director of MA, facilitating timely resolution and follow-up.
Collaborate with cross-functional teams to address payor-related Claims, Utilization Management, and Quality issues, driving towards optimal solutions.
Conduct ad-hoc analysis and reporting to support delegated payor operations, leveraging data insights to inform strategic decision-making.
Prepare and track monthly, quarterly, and annual submissions related to delegated payor operations, maintaining meticulous records.
Stay informed about payor updates, changes, and industry trends, disseminating pertinent information to operational areas.
Facilitate and manage payor meetings, including agenda preparation, documentation, and follow-up actions.
Maintain provider directory submissions in alignment with delegated payor criteria, ensuring accuracy and compliance.
Oversee the resolution of Payor complaints and PCP letter requests, upholding a high standard of customer service.
Supervise and coordinate the yearly UM Fund Challenges process and MA reconciliation process, driving accountability and efficiency.
Undertake additional duties and projects as assigned by management, demonstrating flexibility and adaptability.
Qualifications:
Qualifications:
Bachelor's degree in a related field preferred.
2-3 years of experience in payor contracting, payor operations, or a similar role within the healthcare industry.
Strong organizational and time management skills, with a keen attention to detail.
Excellent written and verbal communication abilities, with proficiency in Microsoft Office Suite.
Analytical mindset with the ability to interpret and analyze data effectively.
Knowledge of healthcare industry dynamics and payor operations.
Familiarity with project management principles and practices.
Ability to work independently and collaboratively in a fast-paced, team-oriented environment.
Strong problem-solving skills and a commitment to maintaining professionalism and confidentiality.
Why Join Us:
Opportunity to make a tangible impact in the healthcare industry and contribute to meaningful change.
Competitive compensation package with comprehensive benefits and remote work options.
Collaborative and supportive team environment that values innovation and continuous learning.
Growth and development opportunities to expand your skills and advance your career.
Join a mission-driven organization committed to improving healthcare outcomes and enhancing the patient experience.