BASIC FUNCTION:
This position is responsible for completing trending and analysis of quality results; as well as driving performance improvement initiatives across the organization. Conducts assigned focus audits across various lines of business; drafting executive summary documents to capture performance results; facilitating meetings as assigned; drafting solutions to address trends; consulting on specific items impacting quality performance; working with operational areas to evaluate quality programs; and communicating value added by each initiative.
JOB REQUIREMENTS:
Bachelor degree and 2 years of experience in claims processing, contract and benefit administration within the health insurance industry OR 6 years of experience in claims processing, contract and benefit administration within the health insurance industry.
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Experience analyzing and resolving problem claims and customer service issues.
Knowledge of claims, inquiry OR membership processes and procedures.
1 years of experience in leading meetings or small groups.
Experience with quality assessment and process improvement practices.
Clear and concise written and verbal communication skills.
Research, analytical, critical thinking and problem solving skills.
Organizational and time management skills.
PREFERRED JOB REQUIREMENTS:
Six Sigma Green Belt certification preferred with project experience.
Experience with Excel, Minitab and tableau software.
PC proficiency including Word, Excel, PowerPoint, Microsoft Live Meeting and email application.
Project Management experience.
This position can be filled in any HCSC office.
*CA
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HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Requirements:
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