Health Plan Operations Specialist

Job Summary

A company is looking for a Health Plan Operations Specialist to support core operational functions within their Health Plan Operations team.

Key Responsibilities

• Analyze claims, provider, and member benefit data to identify discrepancies and issues
• Research and resolve service issues and escalations from various stakeholders
• Monitor key performance indicators and deliver actionable insights for operational improvements

Required Qualifications

• At least 2 years' experience in health plan operations or equivalent education and training
• A bachelor's degree or equivalent education, training, or experience
• Experience working cross-functionally and managing external vendor relationships
• Proficiency in Microsoft Excel; experience with data analysis and visualization tools is preferred
• Ability to work remotely in Texas with quarterly travel to corporate headquarters