What are the responsibilities and job description for the Senior Analyst Claims Operations position at Mass General Brigham?
Site : Mass General Brigham Health Plan Holding Company, Inc.
At Mass General Brigham, we know it takes a surprising range of talented professionals to advance our missionfrom doctors, nurses, business people and tech experts, to dedicated researchers and systems analysts. As a not-for-profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community. We place great value on being a diverse, equitable and inclusive organization as we aim to reflect the diversity of the patients we serve.
At Mass General Brigham, we believe a diverse set of backgrounds and lived experiences makes us stronger by challenging our assumptions with new perspectives that can drive revolutionary discoveries in medical innovations in research and patient care. Therefore, we invite and welcome applicants from traditionally underrepresented groups in healthcare people of color, people with disabilities, LGBTQ community, and / or gender expansive, first and second-generation immigrants, veterans, and people from different socioeconomic backgrounds to apply.
Job Summary
The Senior Operations Analyst is responsible for identifying project process changes and identifying & implementing process improvements in conjunction with the Claims Management Team. This includes all updates from key project teams, business requirements documents, departments policies & procedure, job aids, desktop procedures, etc. The person in this role must be committed to the successful implementation of key corporate projects and helping the Claims Department to improve the customer experience it provides to internal and external customers.
The ideal candidate has a large claims background in an HMO / health insurance setting.
Qualifications
Principal Duties and Responsibilities :
Represents the Claims Department in process changes, corporate project related meetings as appropriate. For example, Childrens Referral Project, Novologix, Retro enrollment.
Alternate to the Claims Solutions Manager in representing the department.
Identifies system deficiencies and recommends workaround processes.
Works collaboratively with the Management Team to improve the efficiencies of the department via process review and improvements.
Collaborate with corporate training members and subject matter experts (SMEs) to assure the development of learning resources, visual aids and presentations to create and continuously improve the departments ability to understand and implement new projects, significant process changes, or new products.
Helps to create and maintain source documentation (desktop procedures, job aids, etc) on SharePoint by participating in meetings as it relates to claim processing regarding new or changed processes, corporate initiatives and resulting system changes.
Identify business process improvement opportunities and escalate the potential improvement appropriately. Identify improvements in the content management tools to create the appropriate resources for representatives to access information to assist the member / provider.
Demonstrate commitment to providing customer-focused quality service.
Hold self and others accountable to meet commitments.
Ensure diversity, equity, and inclusion are integrated as a guiding principle.
Persist in accomplishing objectives to consistently achieve results despite any obstacles and setbacks that arise.
Build strong relationships and infrastructures that designate Mass General Brigham Health Plan as a people-first organization.
Other duties as assigned with or without accommodation.
Additional Job Details (if applicable)
Education
- Bachelor's Degree Analysis required or Bachelor's Degree Related Field of Study required
Can this role accept experience in lieu of a degree?
Experience
Knowledge, Skills and Abilities
Physical Requirements
Remote Type
Remote
Work Location
399 Revolution Drive
Scheduled Weekly Hours
Employee Type
Regular
Work Shift
Day (United States of America)
EEO Statement :
Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and / or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.
Mass General Brigham Competency Framework
At Mass General Brigham, our competency framework defines what effective leadership looks like by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
