Product Operations Specialist - Medicaid Authorizations

2 days ago

🇺🇸 United States – Remote

🐊 Florida – Remote

Although this job is listed in Florida, this company may be open to hiring remote in other states.

🌲 North Carolina – Remote

Although this job is listed in North Carolina, this company may be open to hiring remote in other states.

+2 more states

🐊 Florida – Remote 🌲 North Carolina – Remote 🚗 Michigan – Remote 🏰 Missouri – Remote

💵 $54k - $97.1k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

⚙️ Operations

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Centene Corporation

WebsiteLinkedInAll Job Openings

Contracting • Network Development • Managed Care

10,000+ employees

Founded 1984

⚕️ Healthcare Insurance

🤝 Non-profit

🌍 Social Impact

Description

• Supports the implementation and/or drives the ongoing operational maintenance of assigned product(s) or service area(s) • Creates and maintains reporting tools to effectively analyze and develop process improvement opportunities • Role supports Medicaid Electronic Visit Verification (EVV) portals for Providers • Serves as the subject matter expert (SME) for the assigned product(s) or service area(s) • Drives assigned operational aspects of the product(s)/service(s) • Assesses operational performance and escalations • Monitors assigned internal/external relationships to ensure compliance • Develops effective relationships with key partners and stakeholders • Proactively identifies trends and root cause analysis to drive resolution • Creates reports and supports business review presentations to key stakeholders • Participates in and supports department and/or product strategic planning activities • Manages projects including implementations for delegated functions • Ensures member or other stakeholder communications contain appropriate information

Requirements

• A Bachelor's Degree in business administration / related field required or equivalent work experience • 2+ years of experience in Leading or supporting projects in Benefits, Product Management, Marketing and Sales, Strategic Planning, and/or Project Management • -OR- Data analysis and process improvement in Benefits, Healthcare or Regulatory/Government Affairs • -OR- Vendor management or oversight; preferably with healthcare vendors • 2+ years of experience in customer service experience in a healthcare contact center or customer service environment dealing with claims, grievances pharmacy and appeals authorizations in one or more of Medicare, Medicaid, PDP, Exchange etc.

Benefits

• competitive pay • health insurance • 401K and stock purchase plans • tuition reimbursement • paid time off plus holidays • flexible approach to work with remote, hybrid, field or office work schedules