Operations Analyst

HealthPlan Services is a leading managed health care services company, providing distribution, enrollment, billing and collection, claims administration, and risk services for health care payors and providers. HPS customers include insurance companies, HMOs and other managed care organizations, and organizations with self-funded health care plans. Based in Tampa, Florida, the company serves over 100,000 businesses, covering over 1.6 million members in the United States.

Job TitleOperations Analyst

 

 

Primary Function

Position is the subject matter expert (SME) responsible for overseeing the functions of the business unit, and making business process improvements.

 

Responsibilities include:SME of all operational processes, including, but not limited to, Case Implementation, Enrollments, and Billing.SME of all products/coverages/plans offered on the carrier platform.Performing analysis of case, process, or system issues.  Working with appropriate internal and external resources toward resolution of these issues.Project management for CIGNA requests and initiatives.Analyze current processes, and identify/recommend possible process improvements or system enhancements to optimize operational capability.Document and drive system change requests, report requests, and incident reports (problem calls).Writing business requirements for requested system changes.Obtaining time and cost estimates from IT based upon business requirements.  Communicating estimates back to carrier.  If approved, working with IT to put request through change process.Documentation of processes, systems, and workflows.Special projects and additional responsibilities as needed.Performing User Acceptance Testing (UAT) on system changes or enhancements.Facilitate User Acceptance Testing with client, if applicable.Establishing and maintaining a training program for new hires.Working as liaison between carrier and IT to implement project requests.Acting as backup for operations team during peak processing periods.

 

 

Minimum Education & ExperienceBachelors or equivalent work experience.WordExcelVisio a plus.2+ years experience in group insurance experience preferred; with knowledge of Life, AD&D, Disability, and Dental product administration.Experience in case installation and/or enrollments.Business Analysis experience preferred.Project Management experience preferred.

 

 

 

Expertise Problems follow a standard pattern but involve a variety of administrative and/or technical solutions.Symptoms and facts may be incomplete, but the existence of a problem is apparent.  Gaps must be filled by further inquiry. Judgment is required to make decisions regarding planning, performing and sequencing operations within defined limits of recognized or standard methods or procedures.

 

 

Accountability and SupervisionAccountable for own work.  Able to work autonomously.Able to work in tandem with and be accountable to direct superior.

 

 

Job KnowledgeBasic job skills plus supplemental knowledge of other operations within the function.  Requires experience through 1-2 business cycles, generally 1-2 years, in order to assume responsibility for the exchange or coordination of information or activities.Good typing skills.

 

 

 

Computer SkillsKnowledge of Microsoft Office Suite as well as other business related software.