REGIONAL OPS ANALYST (BA) in Cypress, CA at Beacon Health Options

Date Posted: 7/27/2018

Job Snapshot

Job Description

ABOUT THE POSITION

We are currently seeking a dynamic REGIONAL OPS ANALYST to join our team at our office in Cypress, CA. Under the direction of the RCOO, the Analyst Regional Operations is a key contributor to the Ops Pod: a team of customer-facing cross-functional operations experts tasked with ensuring that designated clients receive consistent, high-quality operations support. Each Ops Pod will manage an average of 4-5 clients, but may be dedicated to a single client or span as many as 8 depending on client size, geography, and complexity. The Analyst will work to proactively identify client operational issues, participate in a regular prioritization process, and lead root cause analysis to create scalable, lasting solutions to operational problems.  The Analyst must have a working knowledge of operational areas, claims, calls, A &G, Network, credentialing, provider data, EDI, reporting, and audit. 

Position Responsibilities:

  1. Support onboarding of clients onto Beacon’s new regional model, including interfacing with client teams and Beacon Account Partnerships teams to ensure incoming client operational issues are directed to the Pod.
  2. Contributes to team discussions and development of solutions for client operational issues assigned to the team, always with the intention to leverage the range of expertise on each team in order to generate high quality, scalable and lasting solutions.
  3. Develop and maintain effective working relationships with Corporate Services, Service Centers, and Regional Clinical/Quality in order to deliver against client service needs.
  4. Contribute to the reduction of client turnaround time by creatively and collaboratively resolving applicable issues up front, and delivering high-quality, pre-solutioned tickets to Central Operations when an issue cannot be resolved within the Pod.
  5. Develop and implement effective processes to improve operational performance against client Service Level Agreements (SLAs) and Performance Guarantees (PGs).
  6. Have a working knowledge of operational areas, claims, calls, A &G, Network, credentialing, provider data, EDI, reporting, and audit. 
  7. Develop strong client relationships built on trust and collaboration. Manage client expectations throughout the solutioning cycle via regular communication on designated topics or issues.
  8. Actively participates in cross-training with other team members, each educating on their area of expertise as well as learning other areas through training provide by other team members, with the overall goal to develop a strong, cross-functional team prepared to address a wide variety of client-generated operational issues.
  9. Contribute to the development of a repeatable model for operational issue resolution, for example by collaborating with other Ops Pod Team Members to synthesize patterns across clients with the goal of developing a “playbook” containing a range of client contexts, problem types, steps to effective resolution (including key internal and external personnel), and watch-outs.
  10. Lead periodic forums with other Ops Pods to ensure consistency in issue resolution model across clients and across regions, as assigned.
  11. Collaborate with Regional Operations Monitoring function to proactively identify operational issues with designated clients and support ongoing improvement of Beacon’s Operations Monitoring capability by providing insight on common issues and value-added metrics to track.
  12.  Adheres to all Beacon policies and procedures and standards of operations.
  13. Completes all required and assigned trainings.
  14. Attends all mandatory company or department meetings.
  15. Displays a positive, constructive, and helpful demeanor that is conducive to a safe and respectful work environment.
  16. Travel to all company sponsored events, trainings, and locations based on business needs.
  17. Performs special projects and other duties as assigned and required.
  18. Other duties assigned.

Position Requirements:

Education:  High School diploma or GED required.  Bachelor’s degree in related field preferred.

Relevant Work Experience:          

  • Three (3) to five (5) years of professional level experience in a technical operations role in a healthcare environment may be substituted for the degree, in addition to the work experience required below.
  • Minimum three (3) years of progressively responsible professional experience, with at least two (2) of those years in a client-facing operations job.
  • One (1) of those years in a managed care environment is strongly preferred.
  • Have a working knowledge of operational areas, claims, calls, A &G, Network, credentialing, provider data, EDI, reporting, and audit.
  • Strong interpersonal skills and good written and verbal communication skills.
  • Advanced computer skills required, including working knowledge of MS Office: Word, Excel, and PowerPoint.

 TO APPLY

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Beacon Health Strategies, LLC., a Beacon Health Options company, is proud to be an Equal Opportunity Employer as well as a Drug Free Work Environment. EOE/M/F/Veterans/Disabled

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