Health Plan Operations Specialist

Thomas Jefferson University

Philadelphia, Pennsylvania, United States
Health plan operations and contracts
Internal appeals processes administration
Regulatory reporting obligations management
Works with EOLA attorneys to ensure efficient and effective legal services for the Thomas Jefferson University and Jefferson Health Plans community

Job Summary

  • Works with EOLA attorneys to ensure efficient and effective legal services for the Thomas Jefferson University and Jefferson Health Plans community.
  • Manages administration of internal appeals processes, regulatory reporting obligations, and contract template development initiatives.
  • Jefferson offers a comprehensive package of benefits, including medical, dental, vision, retirement plans, and tuition assistance.

Matching Summary

Works with EOLA attorneys to ensure efficient and effective legal services for the Thomas Jefferson University and Jefferson Health Plans community.

Skills & Requirements

Must-have

  • Health plan operations and contracts
  • Internal appeals processes administration
  • Regulatory reporting obligations management
  • Contract template development coordination
  • Interface with business persons and executives

Nice-to-have

  • Collaborate with EOLA attorneys
  • Support policy development
  • Cultivate client relationships
  • Participate in relevant committees

Key Requirements

  • Bachelor's Degree
  • 5 years of relevant experience
  • Experience managing annual reporting
  • Experience managing complaints, grievances, and appeals
  • Proficient in Microsoft Office Suite
  • Experience reviewing, negotiating, and drafting agreements preferred
  • Background in health plan and regulated insurance industry preferred

Work Rights

Not specified

Tailored Resume

Cover Letter