Health Plan Operations Analyst- Ashville NC Area - Charlotte, United States - CareSource

Description

Job Summary:
The Health Plan Operations Analyst I reviews and analyzes the effectiveness and efficiency of existing market operation processes and systems and participates in development of solutions to improve or further leverage these functions

Essential Functions:
Participates in the development of new market operation initiatives from concept to implementation and provide statistics measuring progress throughoutMarket process issues

ID card issue resolving wrong co-pay information.

Helping to align the mismatches in our Single Case Agreements where policy does not match market direction and operations is doing something completely different (project facilitation).

Marketplace state competitive analysis.
Bringing existing membership numbers, eligibility numbers and local competitive intelligence together to facilitate and make decisions with market president.
Assist Market President, BD and Operations with project management or NC Medicaid contractCollect and analyze data in support of business case creation and realizationContribute to ensuring operational effectiveness by assisting in the development of strategic plans for market operations, including business, financial, and operational goals and objectivesAssist in the review of reports and data for pattern identification, special cause variation identification, trend analysis, or other techniques; prepare and deliver summaries, recommendations, or alternatives of the analyzed informationDevelop, document and perform testing and validation as neededWork with peers to achieve cross-functional capability with project execution and subject matter expertiseParticipates in the discussions of challenging the standard thinking with new ideas, approaches, and solutions which focus on process improvement and growthPerform any other job duties as requestedEducation and Experience:Bachelor's degree in Engineering, Business, Finance, Economics or related field or equivalent years of relevant work experience is requiredMinimum of one (1) years of analytical experience is preferredA minimum of three (3) years of health care operations or project management experience is preferredCompetencies, Knowledge and Skills:Advanced proficiency in Microsoft Office Suite to include Word, Excel, Access and PowerPointFamiliar with a variety of analysis concepts, practices and proceduresExcellent written and verbal communication, facilitation and presentation skillsStrong interpersonal skills and high level of professionalismEffective listening and critical thinking skillsEffective problem solving skills with attention to detailAbility to work independently and within a teamStrong analytical skillsAbility to create and maintain excellent working relationshipsTime management skills, ability to develop, prioritize and accomplish goals with a sense of urgencyAbility to effectively interact with all levels of management within the organization and across multiple organizational layersAbility to multi-task and remain flexible during organizational and/or business changesLicensure and Certification:None

Working Conditions:
General office environment; may be required to sit or stand for long periods of timeMay be required to travel occasionally

Compensation Range:
$52, $83,900.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.


Compensation Type:

SalaryCompetencies:
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