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Job Description
- Req#: 1804
- Review issues reported by Plan Managers and Executive Directors. Work across the Operational team and vendor to solution issue.
- Reviews issue board and resolutions to determine opportunities.
- Collaborate with cross-functional teams to streamline workflows and enhance efficiency.
- Identify and implement solutions to address operational challenges and improve provider/Plan satisfaction.
- Serve as a point of contact for provider inquiries and issues, ensuring timely resolution.
- Ensure compliance with regulatory requirements and organizational policies.
- Maintain detailed documentation of processes, solutions, and outcomes.
- Work closely with internal teams, including operations, and customer service, to align provider solutions with organizational goals.
- Communicate findings and recommendations effectively to stakeholders.
- 3 or more years' experience in problem solving and prioritizing issues.
- Excellent communication and interpersonal skills.
- Ability to manage multiple priorities and work in a fast-paced environment.
- 3 or more years in Medicare/Managed Care Health Plans, ability to interpret and implement regulatory guidance.
- Experience in healthcare or provider operations.
- Familiarity with provider management systems and software.
At Curana Health, we're on a mission to radically improve the health, happiness, and dignity of older adults-and we're looking for passionate people to help us do it.
As a national leader in value-based care, we offer senior living communities and skilled nursing facilities a wide range of solutions (including on-site primary care services, Accountable Care Organizations, and Medicare Advantage Special Needs Plans) proven to enhance health outcomes, streamline operations, and create new financial opportunities.
Founded in 2021, we've grown quickly-now serving 200,000+ seniors in 1,500+ communities across 32 states. Our team includes more than 1,000 clinicians alongside care coordinators, analysts, operators, and professionals from all backgrounds, all working together to deliver high-quality, proactive solutions for senior living operators and those they care for.
If you're looking to make a meaningful impact on the senior healthcare landscape, you're in the right place-and we look forward to working with you.
For more information about our company, visit CuranaHealth.com.
Summary
This role involves supporting Plan Management and ASC Executive Directors by triaging incoming issues, handling escalations and developing solutions to enhance Provider Solutions Team productivity and processing. The ideal candidate will have strong problem-solving skills, a collaborative mindset, and a passion for improving healthcare processes.
Essential Duties & Responsibilities
Plan Management and Executive Director Support
Process Improvement:
Provider Support:
Compliance and Documentation:
Collaboration and Communication:
Qualifications
Qualifications:
Preferred Skills:About the company
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