Operations Analyst and Supervisor
4 weeks ago
Conduct quality review of audit reports for administrative accuracy and adherence to policies and timely submission to clients
Review claim selections to ensure adherence to program guidelines.
Collect and analyze quality assurance data for public sector client meetings and internal metrics
Conduct monthly quality assurance review of staff time trackers
Create and maintain forecasting tools for oversight on key performance indicators and emerging trends
Oversee program training documents, SOPs, and working instructions. Lead quality-focused remedial training sessions for team. Assist managers with maintaining training records
Identify, lead and manage special projects and program initiatives
Mentoring and developing team members using agile concepts.
Bachelor's degree or equivalent work experience
Minimum of 4 years of related experience in Pharmacy and/or Dental Benefit Management, Group Insurance or Health Care Operations
Highly proficient in Microsoft Access & Excel, and data warehousing applications
Experience with compiling, manipulating or validating large pieces of data
Excellent organizational, planning and critical thinking skills
Proven interpersonal skills and ability to work well with senior management and high-level external contacts handling sensitive or confidential information is critical
Ability to work with minimum management oversight on multiple projects with competing priorities
Ability to work a flexible schedule in high pressure environments with urgent deadlines
Proven time and resource management skills; Policy can be reviewed at this link.
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