Under general supervision of the Operations Manager, the Operations Specialist position will assist with coordinating the Plan’s operational efficiency. This position will perform general office functions. This includes replying to the inquiries received through the department’s email account, electronically organizing vendor reports upon receipt, and troubleshooting business processes with internal staff and external partners. This position works closely with others to enhance overall member and stakeholder satisfaction. Operations Specialist will assist with communicating concerns or improvements to daily processes. The Operations Specialist will support implementing new strategic and departmental goals.
Essential Duties (at least 5 that are non-negotiable duties and are absolutely pertinent to successfully completing the job without accommodations):
An Essential job function meets the following tests:
• Work assigned shift(s) (days and/or weekends).
• Assists with creating, editing, and distributing member materials through fulfillment and other communication methods.
• Provides general guidance to staff in order to answer inquiries/ concerns, and has the ability to write and verbally communicate.
• Ability to troubleshoot and problem solve successfully with others.
• Electronically organize vendor reports upon receipt.
• Experience with Microsoft Word, Excel, and internet.
• Ability to pay close attention to detail, and manages tasks without close supervision.
• Ability to participate with staff and community partners respectfully and professionally.
• Ability to multitask.
• Pays attention to detail; independently works without close supervision.
• Some knowledge of the healthcare delivery system or managed care or health insurance.
• Excellent problem solving skills.
• Strong listening, verbal, and written communication skills.
• Proficiency with Microsoft Word, Excel, Power Point and use of the internet.
People Management/Department Management/Business Unit Management:
• Assists with implementation of new or existing service line initiatives.
• Adheres to all local, state, and federal regulations.
• Participates as member of company.
• Responds to the Plan’s or departmental needs and concerns.
• Works well with others.
• Accepts beneficial feedback, and takes the appropriate steps to implement changes.
MINIMUM EDUCATION: High school diploma or GED.
MINIMUM EXPERIENCE: One year work experience in a Managed Care Organization, health insurance, or a healthcare related field.
PREFERRED EDUCATION: One year of college.
PREFERRED EXPERIENCE: Three (3) years of work experience in a Managed Care Organization, health insurance, or a Healthcare related field.