Job Summary: Under the general direction of the Director of Operations or designee, schedules and supervises the operation of designated programs in support of Quality Assurance; URAC Accreditation; Nurse and Provider Licensing; Credentialing, Board Certification; clinical services; Nurse Helpline; Stop Loss program; Short and Long-term Disability Review program; Utilization Management program; Case Management program and Call Center Operations. Recommends and supports various administrative and operational workflows, carries out said tasks and/or facilitates the other staff involved in successful programs and projects
Essential Duties and Responsibilities:
- Support the Administration in daily operations.
- Maintaining various spreadsheets relating to operations.
- Support Quality Assurance Program by participating in Quality Committee meetings.
- Conduct monthly reviews of Nurse and Provider licenses, credentials and board certification expirations in each state, updating the credentialing system, notifying staff and providers of upcoming renewals and coordinating paperwork as needed.
- On a regular basis, review the Office of Inspector General Exclusion Website and download/document results.
- Organizing and filing various important documents.
- Ensure next-day services are set on a daily basis.
- Perform general operational duties in to include but not limited to reviewing documents for quality, collating and processing paperwork between departments.
- Upload documents within our internal database.
- Handle and respond to emails within a reasonable time.
- Perform other duties as assigned.
Education and/or Experience
- Strong Excel and Data Entry Experience
- Accounting Systems or Electronic Medical Records exp. preferred, but not required
- Associate Degree or experience commiserate to Associate Degree.
- Minimum of two (2) years of program support experience. Knowledge and skills:
- Excellent interpersonal skills
- Prioritize workflow and urgent requests are met.
- Knowledge of program or project workflows
- Knowledge of working with databases or electronic medical record systems
- Excellent organizational skills
- Excellent communication skills
- Have the ability to work and use multiple systems/programs.
…Pay Statement and Pay Transparency Laws: rate of pay listed is on a per hour basis. You will be entitled to health insurance once employed for 60 days and you must work 30 hours per week, on average, per month to enroll and maintain health insurance through Complete Staffing Solutions. Once both qualifiers are met you must complete the enrollment packet and your benefits will start on the first of the subsequent month. ..It is our policy to provide equal employment opportunity to all individuals regardless of race, color, sex, sexual orientation, religion, disability, age, veteran status, ancestry, national or ethnic origin or any other legally protected class. We are committed to a diverse workforce. We value all employees’ talents and support an environment that is inclusive and respectful. We are strongly committed to this policy, and believe in the concept and spirit of the law.#ZIP