Material Control Coordinator
KPS Global LLC
Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed care organization quality review, and quality assurance for programs serving individuals with developmental disabilities. Qlarant is also a national leader in fighting fraud, waste and abuse for large organizations across the country. In addition, our Foundation provides grant opportunities to those with programs for under-served communities. Best People, Best Solutions, Best Results Job Summary Receives complaints from a variety of sources. Interviews complainants or beneficiaries concerning the Medicare Advantage or Prescription Drug Programs to determine disposition of case. Researches subjects and beneficiaries of received complaints. Essential Duties and Responsibilities Communicates with beneficiaries, plans, pharmacies, and providers as needed to resolve complaints. Evaluates the facts of a complaint and researches additional information as necessary. Compiles findings and determines if appropriate for closure or presentation to Level II team. Handles a wide variety of confidential situations. Performs data entry of complaints into the case management system and a variety of other databases. Performs minor background research on subjects of interest as required for the screening of complaints. Prepares appropriate letter templates and/or revises the content based on the facts presented in the complaint. Communicates with external customers including beneficiary or individual complainants, representatives from the Senior Medicare Patrol, Plan Sponsors, CMS, and others. Required Skills Business Expertise – Good understanding of how assigned duties contribute to the work of the team. Problem Solving – Uses simple judgment and defined procedures in straightforward situations. Nature of Impact – Direct impact through the accuracy of the tasks performed. Area of Impact – Primarily on closely related work teams. Interpersonal Skills – Information exchange requiring tact and diplomacy is a significant feature of the job. Leadership – This job has no supervisory responsibilities. Functional Knowledge – Knowledge of activities in own job; focus on physical skills gained through training or experience. Project Management – Project/program team member. Required Experience Education Minimum High School Diploma or GED Work Experience Minimum of 0-2 years experience Minimum of 2-4 years experience preferred Qlarant is an Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities. Qualifications Business Expertise – Good understanding of how assigned duties contribute to the work of the team. Problem Solving – Uses simple judgment and defined procedures in straightforward situations. Nature of Impact – Direct impact through the accuracy of the tasks performed. Area of Impact – Primarily on closely related work teams. Interpersonal Skills – Information exchange requiring tact and diplomacy is a significant feature of the job. Leadership – This job has no supervisory responsibilities. Functional Knowledge – Knowledge of activities in own job; focus on physical skills gained through training or experience. Project Management – Project/program team member. #J-18808-Ljbffr
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