Ecommerce Provider Data and Compliance Specialist
Job Description
HealthPartners is hiring for an Ecommerce Provider Data and Compliance Specialist. This position will promote and support compliance related activities within our division and within the organization. Support and coordinate resolution to operational issues, participate in conducting trainings, participate in work groups, and track and monitor regulatory activities. ACCOUNTABILITIES:
- Understands and support HealthPartners Provider Electronic Commerce and Operations options to effectively promote compliance with regulatory areas.
- Understands and supports monitoring of regulatory activities as required by regulatory agencies such as CMS, DHS, NCQA, and MDH.
- Interact with other departmental staff on individual providers, clinic and facility terminations to ensure members are notified in a timely manner as specified by regulators.
- Participates in the creation, review, revision, maintenance and tracking of internal and provider administrative policies and procedures.
- Coordinates provider communications as requested on behalf of Provider E-Commerce and Operations including tracking of required regulatory communications
- Assists with product and delivery network set-up in CPN, tracking and documentation upon request.
- Perform audits on CPN transactions using audit reports and completed provider or delivery network alerts.
- Assist in testing enhancements to the CPN application.
- .Participates in the development and implementation of process improvements.
- Serves as a liaison with internal staff as needed.
- Supports other business staff in ongoing service needs.
- Participates in and assists with business continuity and disaster recovery plans, tests and revisions.
- Performs other duties as assigned.
REQUIRED QUALIFICATIONS:
- Four year degree in a related field (customer service, training, project management, business, or health care) or two years related work experience in lieu of degree.
- Two years work experience in a related field (compliance, claims, electronic commerce, contracting, business or system analysis, customer service, training, project management, health care operations).
- Intermediate Microsoft Excel skills.
- Proven organizational skills.
- Ability to work independently.
- Ability to multi-task in a fast paced environment.
- Strong interpersonal skills.
- Demonstrated analytical and problem solving skills.
- Demonstrated ability to take responsibility for performance and attitude on the job.
- Demonstrated ability to work collaboratively with others both inside and outside the organization.
- Ability to work well with broad and different audiences.
PREFERRED QUALIFICATIONS:
- Training experience, preferably in managed care and/or health care operations.
- Experience in working in a managed care organization or in a provider office.
- Project coordination skills.
About Us
At HealthPartners we believe in the power of good - good deeds and good people working together. As part of our team, you'll find an inclusive environment that encourages new ways of thinking, celebrates differences, and recognizes hard work. We're a nonprofit, integrated health care organization, providing health insurance in six states and high-quality care at more than 90 locations, including hospitals and clinics in Minnesota and Wisconsin. We bring together research and education through HealthPartners Institute, training medical professionals across the region and conducting innovative research that improve lives around the world. At HealthPartners, everyone is welcome, included and valued. We're working together to increase diversity and inclusion in our workplace, advance health equity in care and coverage, and partner with the community as advocates for change.
Benefits
Designed to Support Your Total HealthAs a HealthPartners colleague, we're committed to nurturing your diverse talents, valuing your dedication, and supporting your work-life balance. We offer a comprehensive range of benefits to support every aspect of your life, including health, time off, retirement planning, and continuous learning opportunities. Our goal is to help you thrive physically, mentally, emotionally, and financially, so you can continue delivering exceptional care. Join us in our mission to improve the health and well-being of our patients, members, and communities. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant because of race, color, sex, age, national origin, religion, sexual orientation, gender identify, status as a veteran and basis of disability or any other federal, state or local protected class. Apply tot his job Apply To this Job