Operational Excellence Analyst I (Hybrid)

CareSource Management Services LLC • Dayton, OH • 10h ago

Job Summary: The Operational Excellence Analyst I is responsible for oversight and monitoring of Operations regulatory and accreditation requirements as well as specific HEDIS initiatives. This is a hybrid position for candidates within a 50 mile radius of Dayton OH. Health plan claims experience preferred. Essential Functions: Oversight and monitoring of Operations regulatory requirements Oversight and monitoring of Operations specific HEDIS initiatives and accreditation requirements Identify and perform oversight and monitoring of Claims, Provider Appeals, Provider Services (claims processing only), Provider Life Cycle and/or Enrollment processes Generate monthly reporting, analyze and recommendations based on findings Conduct monthly quality reviews with the Operations Management team Work cross-functionally with the Operations Management team to identify process gaps and drive improvements Perform any other job duties as requested Education and Experience: Associates of Science/Arts degree in Management Information Systems (MIS) or related field or equivalent year of relevant work experience is required Minimum of one (1) year of experience working in a business environment is required Two to five (2 to 5) years of experience in Healthcare Operations is preferred Two to five (2 to 5) years of experience translating business requirements into technical specifications is preferred Competencies, Knowledge and Skills: Intermediate proficiency level with Microsoft Office Suite, including Project and Visio Advanced troubleshooting and problem-solving capabilities Data analysis and process mapping Overall knowledge and understanding of Operations-related systems, technical specifications and processes Basic understanding of claims processing Ability to conduct oversight, monitoring and auditing of operational areas Ability to understand accreditation and regulatory requirements Ability to document and maintain business and system requirements including process flows Ability to analyze processes and produce recommendations for improvements Excellent written and verbal communication skills Effective listening and critical thinking skills Strong interpersonal skills and high level of professionalism Effective problem solving skills with attention to detail Ability to work independently and within a team Ability to develop, prioritize and accomplish goals Working Conditions: General office environment; may be required to sit or stand for extended periods of time May be required to travel, estimated at less than 10% Compensation Range: $46,500.00 - $74,500.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type: Hourly Competencies:

Fostering a Collaborative Workplace Culture

Cultivate Partnerships

Develop Self and Others

Drive Execution

Influence Others

Pursue Personal Excellence

Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

LI-SD1

CareSource is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to race, color, religion, sex, age, national origin, disabil

Similar Jobs

Respiratory Therapist (RT)

The Laurels of Middletown • Middletown, OH • 28min ago

Hospital & Medical Sponsored

$10,000 sign on bonus for FT RT! **Night shift Full-time RT openings only!** Are you a Respiratory Therapist (RT) with a passion for caring for seniors? Join our team! As the Respiratory Therapist (RT), you will assess,...

28min ago

Go to Apply

Respiratory Therapist (RT) - Sign On Bonus

The Laurels of Middletown • Middletown, OH • 28min ago

Hospital & Medical Sponsored

28min ago

Go to Apply

Telemedicine Physician

QuickMD • Centerville, OH • 29min ago

Hospital & Medical Sponsored

About QuickMD: QuickMD is a leading telemedicine provider, delivering high-quality virtual care across 44 states. Since our founding in 2019, we have helped more than 100,000 patients access essential medical treatment,...

29min ago

Go to Apply

Information System Security Officer

CACI International • Dayton, OH • 1h ago

Management & Administrative

Information System Security Officer Job Category: Information Technology Time Type: Full time Minimum Clearance Required to Start: Secret Employee Type: Regular Percentage of Travel Required: None Type of Travel: None Th...

1h ago

Go to Apply

Customer Support Call Taker

Mister Sparky • Dayton, OH • 1h ago

Management & Administrative

Customer Support Call Taker Full Time - Dayton Replies within 24 hours Benefits: Bonus based on performance Health insurance Paid time off Join Our Team of Professional Electricians Do you value professionalism and punct...

1h ago

Go to Apply

Neuroscience Account Manager (Psychiatry) - Dayton, OH

Vanda Pharmaceuticals, Inc. • Dayton, OH • 2h ago

Management & Administrative

Description Vanda Pharmaceuticals (NASDAQ: VNDA) is a specialty pharmaceutical company focused on the development and commercialization of novel therapies to address high unmet medical needs and improve the lives of pati...

2h ago

Go to Apply

Lead, Finance - Environmental

Vontier • Dayton, OH • 2h ago

Finance, Accounting & Banking

Job Overview This Finance Leader plays a critical role in driving the company's financial success by working across our organization to ensure our revenue targets translate effectively into operating profit. This role is...

2h ago

Go to Apply

Outpatient Licensed Practical Nurse - LPN LVN - Dialysis

Fresenius Medical Care North America • Dayton, OH • 10h ago

Hospital & Medical

Why Join Our Team! Rated as one of Forbes' U.S. Best Employers Paid one-on-one training Tuition reimbursement Competitive Pay & Benefits Paid time off 401(K) and much more No experience required Description Provide y...

10h ago

Go to Apply

Outpatient Registered Nurse - RN

Fresenius Medical Care North America • Trotwood, OH • 10h ago

Hospital & Medical

10h ago

Go to Apply

Consumer Banker III (North Lebanon)

First Financial Bank • Lebanon, OH • 12h ago

Finance, Accounting & Banking

We do the right things, right now. We do them in a way that is relevant to our clients. Become a part of our history as it continues to be written! If you are interested and qualified for this role, we invite you to appl...

12h ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.