MarketPlace Enrollment Operations Analyst
Job Ref: 44549
Department: ENROLLMENT AND MEMBERSHIP
Location: New York, NY
Job Type: Regular
Employment Type: Full-Time
Hire In Rate: $50,000.00
Salary Range: $50,000.00 - $50,000.00
MetroPlus Health Plan provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus’ network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlus has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.
The Exchange Operations Systems Analyst will assist management by analyzing data, identifying root causes, recommending and supporting decision making as it relates to MarketPlace Enrollment Processes.
- Daily review and processing of all rejected 834 enrollment file to ensure timely invoicing and enrollment into the MetroPlus
- Conducting both internal/external investigations in order to resolve MarketPlus enrollment complaints expeditiously adhering to all procedures/protocols.
- The Exchange Operations Systems Analyst must ensure that all enrollment issues are handled efficiently and within mandated time frames as required by our regulatory/contractual obligation
- Partner with MIS to resolve problems through root cause analysis and the identification and implementation of short term and long term solutions to the problems.
- Recommend changes to address deficiencies and/or further improve and streamline performance based on analysis findings.
- Work departmentally and interdepartmentally to identify defects; recommend and requests modifications to existing systems to improve departmental performance by supporting quality, operational efficiency.
- Other duties as assigned.
- Computer literate.
- Analytical and problem solving abilities sufficient to effectively define complex problems and solutions in a logical and organized manner.
- Independent thinking.
- Must be self-motivated and goal oriented
- Must demonstrate flexibility
- Integrity and Trust
- Customer Focus
- Functional/Technical skills
- Written/Oral Communication
How To Apply
If you wish to apply for this position, please apply online by clicking the "Apply Now" button or forward your resume, noting the above Job ID #, to:
MetroPlus Health Plan
Human Resources Department
160 Water Street 8th Floor
New York, NY 10038
Attn: Recruitment Unit