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MetroPlusHealth · 1 day ago

Product Implementation Specialist

New York, NY

Full-time

Onsite

Senior Level

$75K/yr - $85K/yr

5+ years exp

MetroPlusHealth is seeking a Product Implementation Specialist who will leverage their expertise in benefits and product knowledge to ensure effective implementation of changes and compliance. The role involves managing the project cycle, collaborating with various teams, and ensuring regulatory adherence throughout the process.

Financial ServicesHealth CareHealth InsuranceInsuranceLife Insurance

Responsibilities

Lead the regulatory implementations for NY State-Sponsored Programs and CMS Medicare lines of business

Manage the full project cycle of implementations from beginning to end

Analyze complex Product benefit configuration and rate implementation projects and build a range of meaningful recommendations

Use data and insights to inform conclusions and support decision making

Proactively gather information to understand business owner needs

Effectively communicate with all business partners including Core Systems, Medical Management, Business Operations, Regulatory and Compliance ensuring appropriate and timely updates to any potentially impacted departments

Review and verify documentation for compliance and operational accuracy

Assist with CPT code verification for benefit implementations ensuring proper configuration

Special projects and other related duties as assigned

Qualification

Medical CodingHealthRules Payor systemProject ManagementMicrosoft ExcelMicrosoft PowerPointMicrosoft WordTrustIntegrityCustomer FocusCommunication skillsDetail-orientedPresentation skills