Skip to content
Medicare Product Implementation & Optimization – Mpio – Specialist – Operations
| Company | Healthfirst |
|---|
| Location | New York, NY, USA |
|---|
| Salary | $71600 – $117470 |
|---|
| Type | Full-Time |
|---|
| Degrees | Bachelor’s |
|---|
| Experience Level | Mid Level, Senior |
|---|
Requirements
- Bachelor’s Degree from an accredited college
- 3-5 years of relevant experience
- Any combination of education and experience that would provide an equivalent background.
Responsibilities
- Leads or participates in product-driven workgroups, to provide input to product designs/enhancements and implementation plans
- Works with key stakeholders (including, but not limited to Regulatory, Claims Configuration, Provider Ops, Appeals & Grievance, Medical Management, Enrollment & Billing, Sales) to identify, scope and accurately implement new benefits, services, or other product changes, update processes and/or edit systems to accommodate regulatory requirements
- Assist with ad hoc projects such as focus group studies, process improvement initiatives and program implementations, when applicable
- Coordinate activities of product or project-specific cross-functional work teams / serve as liaison between product management and all levels of staff to assure ongoing effective administration of products
- Collaborate with various departments to ensure we are pro-actively troubleshooting issues and resolving them in a timely manner
- Monitor internal policies/procedures and job aids on a regular basis to ensure compliance with regulatory requirements and consistence with actual activities
- Support product management leadership in preparing and conducting product and lines of business (LOB) presentations and training to internal and external audiences
- Plan, schedule, monitor, and report on activities related to a project or assignment; ensure communication to all impacted areas
- Serve as a subject matter expert on product benefits and requirements to other business units
Preferred Qualifications
- Healthcare insurance and related experience
- Experience with Microsoft Word, Excel, and PowerPoint
- Strong organizational and project management skills
- Some prior experience in the healthcare industry, specifically in health insurance
- Strong work ethic, attention to detail, ability to effectively manage time, and commitment to developing quality work quickly
- Ability to work independently
- Strong presentation abilities and process-mapping experience
- Excellent written and verbal communication
