Operations Support - Medicare Advantage

11 hours ago

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Description

• Mass Advantage is a Medicare Advantage health plan, located in Worcester, MA. • We are seeking a Operations Support position to assist the Operations team. • Assist with planning, directing, monitoring, and coordinating functions of Operations department. • Direct daily operational functions and large-scale projects. • Prepare departmental reporting, analyze reported information and make recommendations to the COO. • Ensure compliance with state, federal, NCQA, and Mass Advantage requirements. • Produce monthly scorecards to monitor compliance of Delegation Oversight activities and delegate performance metrics. • Support operational performance of claims payment accuracy. • Conduct root cause analysis on systemic issues and formulate action plans.

Requirements

• Bachelor's degree (B. A.) from four-year college or university; or five years related experience and/or training; or equivalent combination of education and experience. • At least 5 years previous experience in Operations of a Managed Care and/or Medicare Advantage Plan preferred. • Expert knowledge of Medicare regulations for Operational functions within a Health Plan.