and written communication skills. Excellent customer service skills. Ability to manage multiple priorities and deadlines...
Job Description: Applies appropriate medical necessity criteria from established medical policies and clinical... practice guidelines to apply concurrent review determinations as described in the Medical Management UM work plan...
Job Description: Product Strategy & Portfolio Management Own the end to end product strategy for the assigned segment, including benefit design, competitive positioning, rate considerations, and portfolio optimization. Establish sho...
Job Description: Assist customers in a timely and accurate manner in phone interactions. Maintain quantity, timeliness, accuracy, and quality performance within established standards that support HMSA's ability to comply with customer pe...
delivery of service. This will include: Efficiently and comprehensively identify the inquirer's reason for contacting... with internal departments that support FEP benefit and claims processing activities such as Medical Management, Customer Relations...
, sourcing decisions, vendor consolidations, and vendor transitions. Support medical cost containment initiatives, budget cycles... experience in procurement, category management, or vendor management. Experience negotiating mid-to-large operational service...
, operational performance monitoring, and service delivery management. Strong analytical and problem-solving skills with the...
with IT ecosystems, including cloud platforms (AWS, Azure), workflow tools (ServiceNow), managed service vendors (i.e., claims... systems. Experience supporting IT service lifecycle, including renewals, vendor transitions, and system implementations...
on business service providers, pricing models, and sourcing opportunities. Identify cost savings, operational efficiency, value..., pricing structures, performance-based models, and service frameworks. Drive measurable savings through competitive sourcing...
Job Description: Serve as Provider Operations subject matter expert on major department and corporate initiatives, projects, process improvement or any other major activity as assigned by management independently. Independently be able ...