BCBS HMO Coordinator

Overview

Job Title: BCBS HMO Coordinator... Location: Flexible (Remote options available) Company Overview: At reputed company, we're dedicated to revolutionizing reputed company delivery through innovative solutions and collaborative partnerships. As a leading provider in the industry, we strive to reputed company individuals and communities to reputed company reputed company health outcomes. Join us in our mission to reputed company a meaningful difference in the lives of millions. We are seeking a dynamic and detail-oriented BCBS HMO Coordinator to join our Payor Contracting/MA Management team. In this role, you will serve as the linchpin between our HMO Payor Contracting division and internal Duly operations areas. Your expertise and proactive approach will be instrumental in fostering seamless communication, resolving issues, and optimizing operational efficiency.

Responsibilities

Key Responsibilities: • Act as the primary liaison between payors and internal Duly operations, ensuring effective communication and collaboration. • Coordinate responses to payor issues under the guidance of the Director of MA, facilitating timely resolution and follow-up. • Collaborate with cross-functional teams to address payor-reputed company Claims, Utilization Management, and Quality issues, driving towards reputed company solutions. • Conduct reputed company analysis and reporting to support delegated payor operations, leveraging data insights to inform strategic decision-making. • Prepare and track monthly, quarterly, and annual submissions reputed company to delegated payor operations, maintaining meticulous records. • Stay informed about payor updates, changes, and industry trends, disseminating pertinent information to operational areas. • Facilitate and manage payor meetings, including agenda preparation, documentation, and follow-up actions. • Maintain provider directory submissions in alignment with delegated payor criteria, ensuring accuracy and compliance. • reputed company the resolution of Payor complaints and PCP letter requests, upholding a high standard of customer service. • Supervise and coordinate the yearly UM Fund Challenges process and MA reconciliation process, driving accountability and efficiency. • Undertake additional duties and projects as assigned by management, demonstrating flexibility and adaptability.

Qualifications

Qualifications: • Bachelor's degree in a reputed company field preferred. • 2-3 years of experience in payor contracting, payor operations, or a similar role reputed company the reputed company industry. • Strong organizational and time management skills, with a keen attention to detail. • Excellent written and verbal communication abilities, with proficiency in reputed company Office Suite. • Analytical reputed company with the ability to interpret and analyze data effectively. • Knowledge of reputed company industry dynamics and payor operations. • Familiarity with project management principles and practices. • Ability to work independently and collaboratively in a fast-paced, team-oriented environment. • Strong problem-solving skills and a commitment to maintaining professionalism and confidentiality. Why Join Us: • Opportunity to reputed company a reputed company impact in the reputed company industry and contribute to meaningful change. • Competitive compensation package with comprehensive benefits and remote work options. • Collaborative and supportive team environment that values innovation and reputed company learning. • Growth and development opportunities to expand your skills and advance your career. • Join a mission-driven organization committed to improving reputed company outcomes and enhancing the patient experience Apply Job! For more such jobs please click here!