Associate, Inquiries and Investigations

This is a fully remote position, open to applicants in Texas.

📋 Description

• Oversee the comprehensive management of cross-functional implementations and projects, which includes creating project plans, engaging stakeholders, mitigating edge cases, and ensuring timely completion.

• Improve processes and carry out data corrections that affect directory accuracy and filing submissions.

• Develop, collect, analyze, and interpret data to guide technology-driven solutions and establish key departmental metrics.

• Execute mitigation strategies that guarantee quality and uphold financial discipline.

• Assess risks and escalations, devise proactive strategies, and collaborate across teams on continuous improvement action plans leading up to final production release.

• Guide team members and support the professional development of colleagues.

• Encourage teamwork and promote mindset shifts to enhance operational efficiency and meet departmental objectives.

• Adhere to all relevant laws and regulations.

• Carry out additional tasks as assigned.

⛳️ Requirements

• A bachelor's degree or 3+ years of equivalent experience.

• A minimum of 3 years of professional experience in provider data or provider network operations within a health insurance organization.

• At least 2 years of experience utilizing data software such as Excel, SQL, or other data analytics tools.

• A minimum of 2 years of experience in comprehensive project management.

• At least 2 years of experience in designing and enhancing workflows along with establishing relevant operating and technical procedures.

• A minimum of 2 years of experience in creating and presenting information and recommendations to Senior Leadership.

• Compliance with all applicable laws and regulations.

🏝️ Benefits

• Employee benefits.

• Unlimited vacation program.

• Annual performance bonuses.

• Medical benefits.

• Dental benefits.

• Vision benefits.

• 11 paid holidays.

• Paid sick time.

• Paid parental leave.

• 401(k) plan participation.

• Life insurance.

• Disability insurance.

• Paid wellness time.

• Wellness reimbursements.