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Experienced Operations Coordinator
2 months ago
The Commercial Appeals and Grievances team conducts thorough investigations concerning the details and situations surrounding member complaints, appeals, and grievances.
In this capacity, you will collaborate with the leadership team to ensure that all Desk Level Procedures (DLPs) are current and precise.
Your responsibilities will include assisting the leadership team with compliance, quality assurance, production metrics, workflow optimization, process enhancements, employee engagement initiatives, and fostering relationships with a diverse array of cross-functional business partners.
Your WorkIn this position, you will:
Serve as a subject matter expert, reviewing operational processes, identifying issues, conducting root cause analyses, and implementing improvements, modifications, and enhancements.
Maintain essential databases necessary for business operations.Create and assess tools and resources that improve operational efficiency, accuracy, and the technical proficiency of unit personnel.
Generate and present reports for management evaluation; alert relevant department managers regarding issues and challenges in operational workflows that require prompt attention.
Act as a subject matter expert in the formulation of written guidelines and document issues as necessary.Support the leadership team through ongoing and future system modifications and enhancements.
Develop and promote employee engagement activities.
Undertake additional tasks as required.
Your Knowledge and Experience
Requires a bachelor's degree or equivalent professional experience.
Requires a minimum of 3 years of relevant experience.
Requires at least 1 year of experience in Appeals & Grievances.
Requires familiarity with the job area typically acquired through experience.
Exceptional attention to detail, analytical, communication, and problem-solving abilities are essential.
Ability to work independently and consistently meet deadlines.
Note:
You may be assigned to a specialized client or other unit, such as CalPERs.
Pay Range:
The pay range for this role is: $66,800 to $93,400 for California.
Note:
This range represents the pay scale for this and various other positions at Blue Shield that fall within this pay grade.
Blue Shield salaries are determined by several factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.
