Sunshine Health · 22 hours ago

Product Operations Specialist Associate

Florida, United States

Full-time

Remote

Entry Level

$22.36/hr - $38.07/hr

1+ years exp

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Hospital & Health Care

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Responsibilities

Under general guidance, drives assigned operational aspects of the product(s)/service(s).

Assesses operational performance and escalations by tracking, analyzing and researching performance level expectations.

Monitors assigned internal/external relationships to ensure compliance with contractual requirements.

Develops effective relationships with key partners and stakeholders to influence and drive operational enhancements.

Proactively identifies trends and root cause analysis to drive resolution of complex escalations; including communications and reporting.

Creates reports and presentations to help department leadership with key stakeholder readouts; including, but not limited to, Senior Leadership Team, Vendors and/or Government agencies.

Participates in and supports department and/or product strategic planning activities.

Provides guidance and support to project including the implementations for delegated functions as needed.

Ensures member or other stakeholder communications contain appropriate information, talking points and FAQs, and are effectively implemented.

Performs other duties as assigned.

Qualification

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Data AnalysisProcess ImprovementProject ManagementVendor ManagementHealthcare KnowledgeStrategic PlanningRelationship Management

Required

A Bachelor's Degree in business administration, Human Services or equivalent.

1+ year of experience in Leading or supporting projects in the following areas Benefits, Product Management, Marketing and Sales, Strategic Planning, and/or Project Management.

Data analysis and process improvement in the following areas Benefits, Healthcare or Regulatory/Government Affairs.

Vendor management or oversight; preferably with healthcare vendors.

Preferred

1+ year of experience in customer service experience in a healthcare contact center or customer service environment dealing with claims, grievances pharmacy and appeals authorizations in one or more of the following Medicare, Medicaid, PDP, Exchange etc.

Other Experience in health care or managed care environment.

Other Experience working the state reporting, regulatory/government affairs.