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Healthcare Operations Coordinator
2 months ago
We are seeking a highly skilled and detail-oriented Healthcare Operations Coordinator to join our Payor Contracting/MA Management team at Duly Health and Care. As a key liaison between our HMO Payor Contracting division and internal operations areas, you will play a crucial role in fostering seamless communication, resolving issues, and optimizing operational efficiency.
Key Responsibilities:- Primary Liaison: Serve as the primary point of contact between payors and internal Duly operations, ensuring effective communication and collaboration.
- Issue Resolution: Coordinate responses to payor issues under the guidance of the Director of MA, facilitating timely resolution and follow-up.
- Cross-Functional Collaboration: Collaborate with cross-functional teams to address payor-related Claims, Utilization Management, and Quality issues, driving towards optimal solutions.
- Ad-Hoc Analysis: Conduct ad-hoc analysis and reporting to support delegated payor operations, leveraging data insights to inform strategic decision-making.
- Reporting and Record-Keeping: Prepare and track monthly, quarterly, and annual submissions related to delegated payor operations, maintaining meticulous records.
- Payor Updates: Stay informed about payor updates, changes, and industry trends, disseminating pertinent information to operational areas.
- Meeting Facilitation: Facilitate and manage payor meetings, including agenda preparation, documentation, and follow-up actions.
- Provider Directory Management: Maintain provider directory submissions in alignment with delegated payor criteria, ensuring accuracy and compliance.
- Complaint Resolution: Oversee the resolution of Payor complaints and PCP letter requests, upholding a high standard of customer service.
- Project Coordination: Supervise and coordinate the yearly UM Fund Challenges process and MA reconciliation process, driving accountability and efficiency.
- Education: Bachelor's degree in a related field preferred.
- Experience: 2-3 years of experience in payor contracting, payor operations, or a similar role within the healthcare industry.
- Skills: 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.
We offer a competitive compensation package with comprehensive benefits and remote work options. Our collaborative and supportive team environment values innovation and continuous learning. We provide 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.
