The Assistant Manager, Operations supports the Associate Director, Operations in management of the daily, on-going operational and administrative components surrounding provider and payer services related to the CAQH ProView solution. The position contributes to the management of service vendors and CAQH processes, development and execution plans, management and improvement of business processes, and monitoring and reporting of operational results. Working with the Associate Director, the position also contributes to the development and implementation of policies and practices.
This role is full-time exempt and reports to the Associate Director, Operations.
- Supports day to day customer needs, resolves issues and escalates priority issues.
- Supports provider engagement and utilization of the product.
- Assists with user interactions and communications relating to CAQH ProView product functionality and utilization including education and problem resolution.
- Responds to customer needs and inquiries related to system usage, functionality and data.
- Liaison between CAQH Account Management team and vendor helpdesk.
- Assists with managing vendor in assigned aspects of delivery and related services; document processing and financial processing for related programs; including contract compliance, service level agreement (SLA) reporting and contributes to overall performance monitoring as designed by the direct supervisor.
- Assists with ensuring compliance with contracted deliverables.
- Supports increasing effectiveness and efficiency of service by implementing improvements to service offerings as assigned.
- Supports customer implementation activities as needed.
- Supports incident management, including break-fix reporting, analysis, resolution and escalation as necessary.
- Assists with billing and reconciliation activities related to programs.
Audit and Compliance
- Maintains all relevant program operational documentation for both CAQH and vendor relating to service delivery and business processes.
- Executes system audits as assigned.
- A basic understanding of customer service excellence and a positive user experience.
- Organized and efficient, with excellent follow-up skills.
- Ability to communicate effectively with teammates.
- Ability to execute action plans as assigned.
- Ability to produce policy and process draft documentation for approval.
- Ability to look at situations from several points of view.
- Analytical mindset with ability to creatively contribute to solving departmental problems.
- Ability to operate in a fast pace and changing environment.
- Displays professionalism and good judgment.
- Microsoft Office applications familiarity required and SalesForce familiarity a plus.
- Minimum three-years’ experience managing BPO vendors in a healthcare setting, with emphasis on customer service delivery.
- Experience in a payer environment a plus.
Bachelor's degree in a major such as marketing, business, communications or related field required; OR appropriate combination of education and relevant experience.
WHO WE ARE
Named one of Modern Healthcare’s Best Places to Work in 2016, 2017 and 2018 CAQH, a non-profit alliance, is the leader in creating shared initiatives to streamline the business of healthcare. Through collaboration and innovation, CAQH accelerates the transformation of business processes, delivering value to providers, patients and health plans.
- COB Smart® quickly and accurately directs coordination of benefits processes.
- EnrollHub® reduces costly paper checks with enrollment for electronic payments and electronic remittance advice.
- CAQH ProView® eases the burden of provider data collection, maintenance and distribution.
- DirectAssure® increases the accuracy of health plan provider directories.
- VeriFideTMTM streamlines credentialing by consolidating and standardizing primary source verification.
- SanctionsTrack® delivers comprehensive, multi-state information on healthcare provider licensure disciplinary actions.
- CAQH CORE® maximizes business efficiency and savings by developing and implementing national operating rules.
- CAQH Index® benchmarks progress and helps optimize operations by tracking industry adoption of electronic administrative transactions.
WHAT YOU GET
CAQH recognizes that its most important asset is its growing team of smart, creative, collaborative, forward-thinking and passionate professionals – and that a comprehensive employee benefits package is an important factor for them in choosing where to work. CAQH offers competitive compensation along with an extensive benefits package for all full-time employees, including medical, dental and vision coverage, tuition assistance and a 401k. Our location in downtown Washington, DC is metro-accessible, has an onsite fitness center and is centrally located to allow our team to take advantage of professional networking opportunities, cultural offerings and a thriving social scene.