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- Identify, create, collect and manage data required to support and improve business performance
- Generate easy-to-interpret reports based on collected data
- Analyze individual cases (e.g. business situations, use cases, preauthorization request, utilization management review, etc.) against existing processes and frameworks to generate a recommended resolution or course of action
- Work with the management team to prioritize suggested changes to existing processes and frameworks
- Other duties as assigned
- Create, write, and manage evaluation plans for a multifaceted health communications project aimed at increasing COVID-19 vaccine confidence
- Lead and participate in the collection, analysis, and interpretation of quantitative and qualitative data as well as social media metrics; provide analytic support to junior team members, as needed
- Lead the OMB/IRB process for data collection, as required
- Responsible for the writing and editing of routine and ad-hoc research and evaluation reports for diverse stakeholders
- Prepare and edit visual presentations of data and information for dissemination including, charts, graphs, tables, etc.
- Contribute to publications and other dissemination products that share evaluation findings and results
- Supervise, lead, and mentor junior level researchers and evaluators
- Author white papers, concept papers, briefs, articles, and other publications for the dissemination of research and evaluation findings and results
- Contribute to business development activities, such as providing technical expertise and writing proposals and grants
Duties for the Healthcare Claims Processor include:
- Resolving pended healthcare claims, prior approval requests and responding to providers.
Analyzing claims to determine whether or not the claims should be approved or denied for payment.
- Reviewing and addressing provider inquiries regarding claim adjudication
- Meeting all required metrics for the position
- Applying knowledge of medical coding and various medical claims forms to the claims process.