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Data Analyst Level 1

Talent Software Services

Description: This position is Remote and Horizon office based representative working when needed. collaboratively with the vendor(s) management staff to ensure that exceptional service is given to our customer. The incumbent facilitates the day- to-day coordination of the vendor(s) customer service and claims operations with Horizon operations.

  1. Acts as the liaison between Horizon-BCBSNJ and the vendor(s) to address day-to-day operational issues.
  2. Identifies and implements process improvements targeted to improve operational efficiencies and delivery of customer service.
  3. Coordinates the delivery of training and education to the vendor(s) to ensure adherence to Horizon business and compliance
requirements. 4. Requests and evaluates Corrective Action Plans for adequacy, works with vendor on required changes, communicates approval of CAP to the vendors, and monitors open Corrective Action Plans. Coordinates guidance, coaching, refresher training and instructions to the vendor(s) staff in order to improve their performance. 5. Standardizes workflows and business processes to ensure compatibility between the Plan and Vendor teams to increase efficiencies. Prepares status reports to keep Horizon management team apprised of daily operations, progress and issues. 6. Assists in the timely resolution of escalated customer problems. 7. Facilitates the resolution of system problems, creating and tracking P-Logs and escalate when required. 8. Monitors inventory levels and assists with developing action plans to keep within acceptable levels. 9. Facilitates meetings/workgroups to drive issue resolution and process improvements. Job Description The information above is intended to describe the general nature of the work being performed by each incumbent assigned to this position. This job description is not designed to be an exhaustive list of all responsibilities, duties, and skills required of each incumbent. Core Individual Contributor Competencies: Personal and professional attributes that are critical to successful performance for Individual Contributors: Customer Focus ccountable Learn Communicate Education/Experience: - Requires Bachelors degree from an accredited college or university, preferably in business administration field. In lieu of a degree, pplicant must have 4 additional years of equivalent and relevant work experience.
  • Requires a minimum of 4 years of experience in vendor management field or relevant field.
  • Requires a minimum of 3 years health care operations experience.
dditional licensing, certifications, registrations: Requires valid drivers license and access to a car. Knowledge:
  • Demonstrates knowledge, understanding and conforms to laws, regulations and policies that pertain to the organizational units business.
  • Requires general knowledge of tasks performed by areas that support the business teams.
  • Requires project management skills.
Skills and Abilities:
  • Must have effective verbal and written communication skills.
  • Demonstrated ability to deliver highly technical information to less technical individuals.
  • Proven time management skills with the ability to manage multiple priorities or tasks.
  • Ability to work in a production focused environment.
  • Exercise sound judgment and strong problem solving skills.
  • Proven ability to ask probing questions and obtain thorough and relevant information.
  • Must be client service focused with effective ability to empathize.
  • Must be detail oriented with strong organizational and data processing skills. Proven ability to follow detailed instructions is essential, along
with excellent math skills.
  • Strong analytical, research and problem solving skills a must.
  • Must function as a self-starter working effectively working across functional lines. Talent Software Services

Vacancy posted 5 days ago
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