We'll put you in the driver's seat on vital projects that have strategic importance to our mission of helping people lead healthier lives. Yes, we share a mission that inspires. We need your organizational talents and business discipline to help fuel ours. It's the opportunity to do your life's best work.(sm)This Business Operations Specialist position is required to handle increased workload associated with Prior Authorization system setup. The Prior Authorization system setup includes the loading of letters, updating of tables, loading clinical guidelines, and updating automated decision trees. This role is vital since without it we will risk incomplete guidelines, incomplete or incorrect approval and denial letters loaded for each client for each migration resulting in increased cost to client and decreased member satisfaction.Primary Responsibilities:Would be responsible for developing tools using G10VBA, Access and excel macrosTools Developed are used for reporting & automating of Existing applicationsAnalyze existing tools to identify opportunities of automationsEnsures that informational needs of our client and internal customers are met by designing and creating tools, which will help in speed up processing with 100% accuracyAttend and provide proactive input at all relevant meetings with key client stakeholdersAnalyzes existing reports and redesigns them for: Ease of useElimination of duplicationConsolidation into more comprehensive reportsInteracts with other departments to determine reporting needs and provides expectations for completionDesigns and creates ad hoc reports to meet client needsSupports the goals of the department by performing ad hoc duties as assigned by the director.Collaborate regarding report design and system developmentShare outcomes information, provide feedback regarding data quality needs, seek review, classification systems, and participate in system design meetingCollaborate regarding benchmarking, data modeling of new reports, survey development, and development of ROI formulasDevelop innovative reports for new products
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.