Healthcare Analyst
: Job Details :

Client is seeking Operations Client Relationship Issue Resolution Specialist to support one of our clients in the Philadelphia, PA area. This is an onsite role, with 2 days WFH.

Job Description  Resolve complex operational issues for high priority clients  Collaborate closely with cross-functional business areas across sales and account management, claims, billing, enrollment, implementation, reporting, and other internal teams.  Manage client-specific issues and requests to completion in an efficient and timely resolution. Identify the root cause of issues, document holistic solutions, and ensure solutions are implemented to prevent recurrence.  Collaborate with cross-functional team members as appropriate to quickly resolve issues that require engagement from various subject matter experts.  Cultivate relationships with Independence Sales and Account leadership and client leadership by strategically summarizing issue details, root cause analysis, remediation pathway, and the potential impact on the member, provider, or client experience. Present findings, plan of action, and results to internal and client leadership teams.  Support the updating of issues in existing issue databases to enable thoughtful reporting on issue management key performance indicators, and ensure clients are kept aware of issue management activities. Identify opportunities for process improvements and recommend solutions to enhance operational efficiency.

Qualifications  Bachelor's degree in healthcare administration, business, or a related field preferred, or extensive experience in issue management, operations, or health insurance.  3+ years of experience in relevant healthcare operations and project management, with self-funded claims experience preferred.  Familiarity with healthcare payer operations and self-funded group management.  Strong analytical skills to identify trends and resolve complex operational issues, ability to tell a story, and provide recommendations.  Excellent communication skills to effectively translate complex issues to leadership stakeholders.  Proficiency in Microsoft product suite (e.g., Outlook, Teams, Excel, PowerPoint).  Project management and ability to bring subject matter experts together and keep deliverables on track.  Demonstrated self-starter with strong problem-solving, attention to detail, analytical, organizational, and writing skills.