Carrier Operations Specialist at HealthSourceRI Details

Carrier Operations Specialist at HealthSourceRI

Faulkner Consulting Group - East Providence, RI

Employment Type : Full-Time

Carrier Operations Specialist

Faulkner Consulting Group is looking to hire an experienced professional to join our team at HealthSource RI (HSRI), Rhode Island’s health insurance exchange. The Carrier Operations Specialist is a critical role on the HSRI team representing HSRI as a general point of contact for all carriers. The Carrier Operations Specialist will be responsible for operational coordination and issue resolution across the different carriers.

Key responsibilities:

• Represent HSRI as a general point of contact across carriers in individual and family medical and dental market for any operational, customer service, or plan related issues, including questions, comments, and escalations.
• Project manage the development, implementation, and strategy of all carrier operating project plans for new and existing projects.
• Coordinate carrier and member escalations that require carrier approval.
• Facilitate carrier workgroup sessions in development of training, process documentation, and changes in operational requirements.
• Continually develop and distribute customer service talking points.
• Identify additional customer service training needs and work with HSRI training leads.
• Collaborate with HSRI tech team on the coordination of technology integration, release scheduling, and carrier testing for enrollment and payment file transactions.
• Single point of contact for HSRI finance team as it relates to carrier transactions and issue resolution.
• Identify long term solutions for process improvement and present to supervisor.
• Manage and plan annual open enrollment activities with carriers including training, enrollment fairs, plan testing, customer service support, and other pieces as developed.
• Facilitate all carrier facing meetings and responsible for follow up of action items.
• Act as the subject matter expert (SME) in design and implementation of new initiatives as outlined by management.
• Identify policy needs and revisions on an ongoing basis, serving as the SME from carrier viewpoint.
• Work on special projects related to carriers as identified by management.

Qualifications/Requirements:

• Bachelor’s degree
• Minimum 3 years professional experience
• Experience working in a highly matrixed and complex organization
• Experience with complex business processes
• Project Management experience
• Proficiency in Microsoft Office
• Experience with health care or health policy or related field required
• Spanish fluency a plus
• Experience with health insurance carrier is a plus

Competencies:

• Thrives in a fast paced, deadline driven, ever changing environment
• Ability to multi-task and manage a prioritized task list without compromising quality
• Self-motivated, able to work independently
• Proven ability to meet deadlines
• Positive “can do” attitude
• Organizational skills, with a strong attention to detail
• Team player with the ability to build collaborative relationships across the organization

Work Environment:

Faulkner Consulting Group is a virtual company, all work is done at client offices. This position is with Healthsource RI at their contact center location in East Providence. Some travel may be required between offices. All work is done in a professional office environment.

Faulkner Consulting Group www.faulknerconsultinggroup.com

Faulkner Consulting Group (FCG) is an experienced health policy consulting firm focused on the intersection of public and private programs. FCG has expertise in national and local trends in health policy, including federal and state health program design and state regulatory policy.

FCG works with payers and providers to tackle health care policy projects with a fundamental commitment to client partnership. We work side by side with our clients to ensure that our policy analyses and guidance fit within the clients’ business models and capacity. We bring an analytical perspective to health policy issues with an emphasis on data-driven decision making.

FCG and HealthSource RI
HealthSource RI offers a place for Rhode Islanders to easily compare health insurance options, learn if they qualify for government subsidies or Medicaid, and enroll in insurance.It provides tools, resources, and information to individuals, families and small businesses to weigh a range of insurance options and choose a plan that fits their needs. HealthSource RI coordinates enrollment, billing and eligibility for tax credits, all in one convenient place, with experts available to help with any questions, concerns or issues.

Since the spring of 2011, Faulkner Consulting Group has been working with the state of Rhode Island to create and implement HealthSource RI. Our consultants oversee many aspects of HSRI design and development, including vendor relationships, financial analysis, coordination with other states, stakeholder communication, and interfacing with federal authorities.

EEO Statement:

It is our policy to provide equal employment opportunity to all persons, without regard to race, color, creed, religion, national origin or ancestry, sexual orientation, gender identity or expression, marital status, age, disability, genetic information, veteran status, or any other legally protected status under local, state, or federal law.

FCG is an at-will, equal opportunity employer. FCG hires and promotes individuals solely on the basis of their qualifications for the job to be filled.

Disclaimer: This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.'
'
Work Location:

• One location

Work Remotely

• Temporarily due to COVID-19

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Health insurance
• Paid time off
• Professional development assistance
• Referral program

Schedule:

• Monday to Friday

Education:

• Bachelor's (Required)

Work Location: One location