Health Plan Quality Control Associate
Health Plan Quality Control Associate
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Job Description
At Collective Health were transforming how employers and their people engage with their health benefits by seamlessly integrating cuttingedge technology compassionate service and worldclass user experience design.
As part of the Member Services team within Customer Experience the Plan Operations team owns specialized processes that require close collaboration with finance legal product and other internal teams. The Plan Operations Plan Structure Launch & Design team (PSL&D) will be responsible for owning and further developing key processes that support and enable the Member Claims team and successful client implementations. PSL&D owns builds and maintains Collective Healths core business logic and system while implementing our clients healthcare plans onto the Collective Health platform.
What youll do:
- Provide subject matter expertise for all quality control activities and provide required training to maintain quality policies and procedures related to the Plans Platform ecosystem.
- Perform regular quality control activities and necessary updates on Plans Platform to ensure all benefit categories CPT codes etc. are current.
- Collaborate with Health Plan Benefits Associates to ensure accurate artifact generation (SBCs SPDs OE takeaways network benefit grids portals)
- Maintain robust quality assurance protocols throughout the implementation process for new and renewal clients.
- Support new and existing team members by holding training meetings and attending office hours to ensure quality standards are understood and upheld
- Own complex and/or high priority benefit builds and modifications for new and existing benefits
- Assist in managing and supporting the endtoend implementation process for new and renewal clients.
- Apply a scalability lens to several key areas in Plan Operations plan stack plan testing data gathering workflows plan design and analytics inquiries and more including:
- Working with software engineers to build internal tools to improve processes
- Collaborate crossfunctionally with Member Claims Product Development Legal Clinical Copy and Client Success teams to delight our customers
To be successful in this role you:
- Have healthcare industry experience and coding knowledge base
- Are selfmotivated intellectually curious and take ownership for everything you do
- Have Excellent Microsoft Office and/or Google Suites skills particularly in Excel / gSheets and PowerPoint / Slides
- Have strong analytical thinking and problemsolving skills to collect organize analyze and disseminate information with extreme attention to detail and accuracy
- Are CPC or CCS certified or have worked in the healthcare industry for at least 1 year
- Think critically and are willing to question the status quo in a constructive and thoughtful manner
- Enjoy adding structure & taking a methodical approach to problems
- Are a committed team player
- Thrive on change and are enthusiastic about being along for the ride and learning from our experiences together
- Possess a passion for Collective Healths mission to transform the health insurance experience for employers and their employees
- Are hyper attentive to details and processes
Pay Transparency Statement
This is a hybrid position based out of our Lehi office with the expectation of being in office at least two weekdays per week.#LIhybrid
The actual pay rate offered within the range will depend on factors including geographic location qualifications experience and internal equity. In addition to the hourly rate you will be eligible for stock options and benefits like health insurance 401k and paid time off. Learn more about our benefits at UT Pay Range
Why Join Us
- Missiondriven culture that values innovation collaboration and a commitment to excellence in healthcare
- Impactful projects that shape the future of our organization
- Opportunities for professional development through internal mobility opportunities mentorship programs and courses tailored to your interests
- Flexible work arrangements and a supportive worklife balance
We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race religion color national origin gender sexual orientation age marital status veteran status or disability status. Collective Health is committed to providing support to candidates who require reasonable accommodation during the interview process. If you need assistance please contact .
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IC
Employment Type
Full Time
