This role involves supporting Plan Management and ASC Executive Directors by triaging incoming issues, handling escalations and developing solutions to enhance Provider Solutions Team productivity and processing. The ideal candidate will have strong problem-solving skills, a collaborative mindset, and a passion for improving healthcare processes.

Plan Management and Executive Director Support

• Review issues reported by Plan Managers and Executive Directors. Work across the Operational team and vendor to solution issue.
• Reviews issue board and resolutions to determine opportunities.

Process Improvement:

• Collaborate with cross-functional teams to streamline workflows and enhance efficiency.
• Identify and implement solutions to address operational challenges and improve provider/Plan satisfaction.

Provider Support:

• Serve as a point of contact for provider inquiries and issues, ensuring timely resolution.

Compliance and Documentation:

• Ensure compliance with regulatory requirements and organizational policies.
• Maintain detailed documentation of processes, solutions, and outcomes.

Collaboration and Communication:

• Work closely with internal teams, including operations, and customer service, to align provider solutions with organizational goals.
• Communicate findings and recommendations effectively to stakeholders.

Qualifications:

• 3 or more years’ experience in problem solving and prioritizing issues.
• Excellent communication and interpersonal skills.
• Ability to manage multiple priorities and work in a fast-paced environment.
• 3 or more years in Medicare/Managed Care Health Plans, ability to interpret and implement regulatory guidance.

Preferred Skills:

• Experience in healthcare or provider operations.
• Familiarity with provider management systems and software.