-
Accident Fund Holdings, Inc. Lansing, United StatesJob DescriptionREMOTE opportunity with required travel to the Lansing, MI office, as needed. The Medical Vendor Oversight Specialist will provide day to day monitoring of relationships and partnerships to ensure the effectiveness of the programs or services offered by the medical ...
-
CorsoCare Lansing, MI, United States Full timeRegistered Nurse - Home Health Care - Full Time · CorsoCare Home Health · Covering Lansing and surrounding areas · Free CEU's · Compeitive Salary · Company paid Life Insurance · Pet Insurance · Comprehensive benefits · Mileage Reimbursement · Tuition Reimbursement · Pos ...
-
Patient Access Rep
2 weeks ago
Franciscan Health Michigan City, United StatesFranciscan Health Michigan City Campus · 3500 Franciscan Way Michigan City, Indiana 46360 · **WHO WE ARE** · With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health ta ...
-
Patient Access Rep
3 weeks ago
Franciscan Health Michigan City, United StatesFranciscan Health Michigan City Campus · 3500 Franciscan Way Michigan City, Indiana 46360 · **WHO WE ARE** · With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health ta ...
-
Communication Systems Operator
2 weeks ago
Franciscan Health Michigan City, United StatesFranciscan Health Michigan City Campus · 3500 Franciscan Way Michigan City, Indiana 46360 · **WHO WE ARE** · With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health ta ...
-
Ct Tech/radiology
2 weeks ago
New Era Staffing Agency LLC Lansing, United States**We are currently looking for a CT Tech for evenings/nights the job is located in Naperville. This can also be a travel assignment if interested** · As a CT Tech, you will be responsible for the use of computed tomography and ensuring that images are accurate and passed on to ph ...
-
Operating Room Technician
3 weeks ago
Franciscan Health Michigan City, United StatesFranciscan Health Michigan City Campus · 3500 Franciscan Way Michigan City, Indiana 46360 · **WHO WE ARE** · With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic healthcare systems in the Midwest. Franciscan Health tak ...
-
Operating Room Technician
3 weeks ago
Franciscan Health Michigan City, United StatesFranciscan Health Michigan City Campus · 3500 Franciscan Way Michigan City, Indiana 46360 · **WHO WE ARE** · With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic healthcare systems in the Midwest. Franciscan Health tak ...
-
Outside Sales Representative
2 weeks ago
MERSINO DEWATERING LLC Michigan City, United States**Outside Sales Representative - **Multiple Positions: Michigan City, IN, Northern Illinois, and Southern Wisconsin** · ***Mersino **is an established and growing competitor in the construction dewatering and pumping industry. Founded in 1988, we pursue those projects requiring a ...
-
K9-handler
3 weeks ago
Platinum Pest Solutions Lansing, United StatesJob Summary: · The K9 Team technician, under the direct supervisor of the K9 team lead will perform tasks assigned by K9 Team Lead or Operations Manager (when applicable) · Supervisory Responsibilities: · - No · Duties/Responsibilities: · Punch in at the appropriate time, and in ...
-
Housekeeper/cleaner
2 weeks ago
Beachwalk Vacation Rentals Michigan City, United States**We are now interviewing & hiring for the upcoming busy Summer season(Memorial Day - Labor Day) - Planned start date week of 5/20** · Modeled after the "Truman Show" movie location - Work with us at Beachwalk Resort & Vacation Rentals · Join our team and be a part of the summer ...
-
Caregiver / Morning Shifts
3 weeks ago
Right at Home Merrillville, IN Michigan City, United States**Benefits**: · - Competitive salary · - Dental insurance · - Flexible schedule · - Health insurance · - Opportunity for advancement · - Training & development · - Wellness resources · Do you want to make a difference in someone's life within the safety of their home providing sp ...
-
Catalyst Process Operator
3 weeks ago
Shell Michigan City, United States**What's the Role?** · - Comply with all safety regulations, policies, standards, and practices · - Operate and monitor process and associated equipment for job area · - Be trained and qualified in all functions of the Operator classification, and operate these functions as assig ...
-
Service Center Technician
2 weeks ago
Vacuum Technique LLC Michigan City, United States**Service Center Technician**: · - Functional area: Service- Country: United States- City: Michigan City- Company name: Vacuum Technique LLC- Date of posting: Apr 17, 2024Our solutions are a key part of most industries - electronics, medical research, renewable energy, food produ ...
-
Leadership & Business Development Trainee
3 weeks ago
JX Truck Center Lansing, United States**JX Truck Center - Lansing is a subsidiary of JX Enterprises, Inc. We have 25 dealerships in 4 states: Illinois, Indiana, Michigan, and Wisconsin. As of this posting, the Lansing dealership has approximately 27 employees in all of their departments.** · **Currently, JX Enterpris ...
-
Legal Assistant
1 week ago
Braje, Nelson & Janes, LLP. Michigan City, United StatesExperience preferred. Proficient in Word, Excel, Outlook, electronic dictation/transcription. Salary commensurate with experience. Benefits and retirement package available. · Pay: From $36,000.00 per year · **Benefits**: · - 401(k) · - 401(k) matching · - Health insurance · - Li ...
-
Bcba
6 days ago
All About ABA, LLC Michigan City, United StatesAll About ABA, LLC is a leading provider of individual and family services in the field of Applied Behavior Analysis (ABA). We are currently seeking a highly skilled and dedicated Board Certified Behavior Analyst (BCBA) to join our team. As a BCBA, you will play a crucial role in ...
-
Departmental Analyst
1 week ago
Resource Analyst 12 (GIS and Data Analyst) Lansing, United States**Salary** · - $ $37.46 Hourly**Location** · - Lansing, MI**Job Type** · - Permanent Full Time**Job Number** · FRD-052**Department** · - Natural Resources**Opening Date** · - 05/14/2024**Closing Date** · - 5/28/2024 11:59 PM Eastern**Bargaining Unit** · - NON-EXCLUSIVE REPRESENTE ...
-
Receptionist/office Assistant
2 days ago
NeuroScience Center Michigan City, United StatesWe are seeking a friendly and organized Medical receptionist to join our growing healthcare team. Fast typing skills would be a plus point. In this role, you will work at the front desk & assist our patients. Your primary duties will include greeting & checking in patients, answe ...
-
Assembler/sequencer
1 week ago
Avancez Assembly Lansing, United StatesDo you want to work at an organization that is people focused, service minded and results oriented, that offers their customers creative problem solving, progressive solutions, and improved outcome? Then Avancez Assembly may be the place for you. We are committed to a culture of ...
Medical Vendor Oversight Specialist, REMOTE with travel required - Lansing, United States - Accident Fund Holdings, Inc.
Description
Job DescriptionREMOTE opportunity with required travel to the Lansing, MI office, as needed.
The Medical Vendor Oversight Specialist will provide day to day monitoring of relationships and partnerships to ensure the effectiveness of the programs or services offered by the medical vendors.
This position will have a wide variety of specialized functions in support of MMP&S with primary focus on cost containment vendors.
This position will conduct due diligence on vendors, including sitting on the selection committee along with brand representatives.Responsible for generating, maintaining, analyzing and reporting the results of audits and review of vendor, monitoring performance and compliance with the contract.
Responsible for performing administrative tasks which may be highly confidential and sensitive in nature utilizing considerable independent judgment.RESPONSIBILITIES/
TASKS:
(Brief bullet points detailing the tasks for this position)
Takes the lead on vendor issues following submitted complaints and provide resolutions to meet internal performance standards.
Direct, communicate, assign and manage work referred to vendors.
Assist in implementing of new vendor services, including communication and workflow/ processes.
Develop and manage vendor relationships including scheduling of meetings, greeting and assisting vendors.
Works closely with manager and brands on request for proposals and request for information. (this would be done if manger was not available or employee was given proxy from manager)
Analyze documents and activities found in the queues such as OnBase, Medata and/or Claim Center etc.
Inform appropriate staff of issues as necessary.
Analyzes trends and reviews reports as requested or scheduled (i.e. metrics, scorecards, compliance, cost center etc.).
Prepares materials for presentation to all customers while maintaining confidentiality.
Trains MMX team and internal customers on the use of reports located on the enterprise claims portal.
Evaluate and monitor medical cost containment vendors based on service needs of the brands and ensure cost containment efforts are being met.
Responsible for ensuring vendor compliance to corporate standards (i.e. timely submission, purchasing, timekeeping, licensing).Conducts annual vendor audits as scheduled or on an as needed basis. Make recommendations for metrics used to measure vendor performance.
Respond to calls, email communication and provides information to vendors, insured, providers or routes calls to the appropriate staff.
Establishes and maintain effective working relationships with all internal and external customers. Develop a strong relationship and partnership with the claims department.
Assist in the development of team goals.
This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.
EMPLOYMENT QUALIFICATIONS:
EDUCATION:
Bachelor's degree in insurance, business or a related field required. Relevant combination of education and experience may be considered in lieu of degree. College level medical courses required. Continuous learning, as defined by AFHI's learning philosophy, is required. Certification or progress toward certification is highly preferred and encouraged. CAWC highly preferred.
EXPERIENCE:
A minimum of one year of experience in an insurance organization or completion of trainee program with demonstrated skills in the areas of medical cost containment vendors, oversight of vendors, auditing and contract review.
SKILLS/KNOWLEDGE/ABILITIES (SKA)
REQUIRED:
(Brief bullet points detailing the skills necessary for this position)
Ability and proficiency in the use of computers and company standard software specific to position.
Knowledge of workers' compensation laws and regulations, including jurisdictional laws.
Effective customer service skills.
Ability to negotiate, build consensus and resolve conflict.
Ability to manage multiple priorities and meet established deadlines.
Attention to detail and analytical skills.
Ability to work independently as well as within a team.
Ability to work effectively in a multi functional business unit.
Excellent oral and written communication skills.
Ability to comprehend consequences of various situations and to make appropriate individuals aware of these to facilitate decision making.
Excellent organizational skills and ability to prioritize work.
Ability to proofread documents for accuracy of spelling, grammar, punctuation, and format.
Ability to effectively exchange information clearly and concisely, present ideas, report facts and respond to questions, as appropriate
Ability to provide customer service by responding appropriately to inquiries or concerns from agents, policyholders, regulatory agencies, management, and employees.
Effective presentation skills in a variety of settings.WORKING CONDITIONS:
Work is performed in an office/remote setting with no unusual hazards. Minimal travel required with occasional overnight stays. Work is required at various times of the day and sometimes weekend work may be required.
The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description.
"Actual compensation decision relies on the consideration of internal equity, candidate's skills and professional experience, geographic location, market and other potential factors. It is not standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $46,100 and $77,200."
We are an Equal Opportunity Employer. Diversity is valued and we will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an "at will" basis. Nothing herein is intended to create a contract.
#LI-MG1
About the Team
Accident Fund Insurance Company of America
#J-18808-Ljbffr
