Health Care

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Title	Health Care Data Analyst and Writer
Categories	Health Care
Job Information	Primary Responsibilities: •Analyzing, mining, mapping, transforming and transferring data, between a variety of data sources using SQL queries and MS SQL Server Reporting Services tools. •Identifying and reporting anomalies found in the data as well as identifying patterns within the data •Work with business users to understand requirements and expectations for ad hoc requests received from them •Developing consistent business rules, data and reporting standards and overseeing the delivery of accurate, timely and complete data and management information/data (membership, clinical and utilization) •Developing automated control reports and tools Qualifications: •Years and Type of Experience oRequired: Minimum of 3-5 years experience in medical data analysis oPreferred: 5-7 Years of experience in medical data analysis •Specific Technical Skills Required: oProficient in Windows based environment, particularly Microsoft Excel, Access, and Word oMS SQL 2003 and MS SQL 2005 skills Required •Previous managed care experience required •Minimum 4 year degree, preferably in Computer Science •Excellent analytical and problem-solving skills •Extremely detail oriented and be able to check and validate own work
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Title	Call Center Team Manager
Categories	Health Care
Job Information	Health Care industry experience is preferred. Bilingual professionals are greatly desired. The Member Services Team Manager is responsible for the development, implementation, enhancement and support of call center systems, technologies and strategies. Oversees the daily operations of all Member Services Department functions; ensures activities run smoothly and efficiently; promotes the image of the company in a professional and positive manner; provides supervision, guidance, coaching, recognition, motivation and training to department personnel; participates in marketing campaigns and product launches; attains sales, quality control and customer service goals. Performs direct supervisory duties of department staff and coordinates staff for coverage in all related areas. Position Responsibilities: • Daily supervision of a team to meet departmental and corporate objectives to ensure that all member, provider and prospect inquiries and issues are resolved in timely manner • Works with management to assure that team is properly staffed based on daily and hourly schedules daily and hourly to meet variable inbound and outbound call volume demands • Provides management oversight to assure that team members are in adherence with established departmental schedules and company policies • Monitors and evaluates inbound/outbound calls and provides coaching to improve service quality, performance and productivity • Provides ongoing performance feedback and formal team member evaluations • Intervenes and takes escalated calls to answer and resolve questions and issues • Monitors call queues and staffing to assure that member calls are answered within the established service levels for the team and call center • Assures that team members have access to the systems and tools necessary to provide member related services • Assures that team member provide all call center services in compliance with regulatory and business policies and procedures • Identifies and recommends process improvement opportunities to improve productivity, performance and customer satisfaction • Other duties as assigned
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Title	Call Center Representative
Categories	Health Care
Job Information	Health Care industry is preferred. Bilingual professionals are greatly desired. Position Responsibilities: • Handle inbound customer calls or e‐mail requires for assigned customer, providing a single point of contact for the specific transaction or issue • Act as the single point of contact for assigned members in order to facilitate and/or expedite interactions within the company • Initiates customer contact to ensure satisfaction with service provided • Thoroughly researches assigned ticket issues and takes appropriate action to resolve and meet turnaround time requirements and quality standards • 80%+ amount of time spent telephonically • Develop tickets requiring additional information in order to make a final determination on the disposition • Update and maintain information in Fortuna account database • Assist management with special projects, as needed • Other duties as assigned Skill Requirements and Preferences: • Experience/knowledge of healthcare industry, preferred • Ability to identify problems, analyze alternative solutions and take action necessary to resolve issue • Good organization skills • Good diction, voice quality and clarity of speech • Must be able to communicate effectively through oral and written methods to members, providers and internal customers • Ability to work flexible schedule • Ability to work overtime as necessary
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