Operations Specialist III

Job Description

Supports Category Management by maintaining database of Care at Home suppliers and ensuring stakeholders are provided with information on new or updated supplier contracts and performing other tasks as requested by Category Management, with minimal day to day supervision. Responds to regulatory requests for information and performs moderately complex project-related work in accordance with established federal, state, and local policies, guidelines, procedures, laws, regulations, and within established service expectations. Responds to requests for help resolving claims and service issues, contacting third party healthcare suppliers to gather and confirm information. Ensures all data is accurate and complete and performs supplier outreach, communication, education, and training; Contributes to monitoring and improving existing processes by performing routine processes independently and complex processes under limited supervision, following defined requirements and accountable for achieving expected results for stakeholders.                                                             

Essential Responsibilities                                                                         

• Ensures legal, regulatory, and compliance adherence by: maintaining database of Care at Home providers and ensuring stakeholders are provided with information on new or updated supplier contracts; responding to regulatory requests for information; and performing moderately complex project related work in accordance with established federal, state, and local policies, guidelines, procedures, laws, regulations, and within established service expectations.
• Contributes to monitoring and improving existing processes by: performing routine processes independently and complex processes under limited supervision, following defined requirements and accountable for achieving expected results for our customer; maintaining, optimizing, and transforming standard and nonstandard processes to increase efficiency of systems
• Pursues effective relationships with others, both internal and external, by proactively providing information, advice and expertise
• Responds to requests for help resolving claims and service issues, contacting third party healthcare suppliers to gather and confirm information; ensuring all data is accurate and complete; and perform supplier outreach, communication, education, and training                                                    

Minimum Qualifications

• Bachelor’s Degree in Business/Business Administration, Healthcare/ Healthcare Administration, or related field OR Minimum three (3) years of experience in data analytics, healthcare business operations or business process analytics, project management or a directly related field.
• Additional 3 years equivalent work experiencefor a total of 6 years in a directly related field may be substituted for the degree requirement.

Preferred Qualifications                                                                              

• Master’s degree may be substituted for the work experience requirements                          
• Two (2) years of experience in healthcare or another heavily regulated industry (e.g., Banking).                                                                                    
• One (1) year of experience in project management.                                                                                      
• One (1) year of experience in process improvement.                                                                                   
• One (1) year experience working with contract management software.                                     

Benefits

• Transportation.
• Life insurance.
• Medical insurance.
• Solidarity association.
• Growth plans.
• Additional days off.

K3