Description

You design and oversee functional workflows within healthcare operations and data environments, focusing on enrollment, claims, customer service, and appeals.

This role is remote.

Responsibilities

• Manage healthcare operations workflows across the member lifecycle.
• Extract data from various sources and warehouses using SQL to support business needs.
• Lead teams to complete assigned projects and deliverables on time.
• Create executive-level presentations based on analytical findings.
• Apply analytical skills to healthcare quality measures and utilization studies.

Required Skills

• Minimum of 3 years of healthcare industry experience, specifically within a health plan, pharmacy, or health tech environment.
• Working knowledge of Medicaid and Medicare regulations and operations.
• Proficiency in SAS for data analysis and reporting.
• Experience with SQL for data extraction and manipulation.
• Proven project management experience leading teams and delivering results.
• Experience in healthcare analytics, quality measures, and utilization studies.
• Proficiency in Microsoft Office Suite, including Access, Excel, PowerPoint, and Word.
• Bachelor's Degree.

Preferred Skills

• Strong background in healthcare quality metrics.

Key Skills

Education

Bachelor's Degree