School Liaison Product Operations Specialist

Support the end-to-end operations of assigned health plan products by building stakeholder alignment, tracking performance, and driving process improvements.

Responsibilities

• Act as the subject matter expert (SME) for assigned product(s) or service area(s)
• Own and drive the operational execution of assigned product(s)/service(s)
• Assess operational performance by tracking, analyzing, and researching performance level expectations
• Escalate issues as needed based on performance signals and documented analysis
• Monitor internal and external relationships to ensure compliance with contractual requirements
• Build effective relationships with key partners and stakeholders to influence and deliver operational enhancements
• Identify trends and perform root cause analysis for complex escalations, including communications and reporting
• Create reports and support business review presentations for key stakeholders, including:
  • Senior Leadership Team
  • Vendors and/or Government agencies
• Participate in and support department and/or product strategic planning activities
• Manage projects, including implementations for delegated functions as needed
• Collaborate with internal and/or external partners to execute assigned business objectives and initiatives
• Ensure member or other stakeholder communications include appropriate information, talking points, and FAQs, and are effectively implemented
• Perform other duties as assigned
• Comply with all policies and standards

Requirements

• Work authorization: Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future
• No sponsorship: Sponsorship and future sponsorship are not available, including employment-based visa types
  • H-1B
  • L-1
  • O-1
  • H-1B1
  • F-1
  • J-1
  • OPT
  • CPT
• Education: Bachelor’s Degree in business administration or related field
• Experience: Required or equivalent work experience

Candidate Experience

• 2+ years of experience leading or supporting projects in:
  • Benefits
  • Product Management
  • Marketing and Sales
  • Strategic Planning
  • Project Management
• Data analysis and process improvement experience in:
  • Benefits
  • Healthcare
  • Regulatory/Government Affairs
• Vendor management or oversight, preferably with healthcare vendors
• 2+ years of customer service experience in a healthcare contact center or customer service environment involving claims, grievances, pharmacy, and appeals authorizations for one or more of:
  • Medicare
  • Medicaid
  • PDP
  • Exchange
• Preferred: Other experience in a health care or managed care environment
• Preferred: Other experience working the state reporting and regulatory/government affairs

Benefits

• Competitive pay
• Health insurance
• 401K and stock purchase plans
• Tuition reimbursement
• Paid time off plus holidays
• Flexible approach to work with remote, hybrid, field, or office work schedules
• Total compensation may also include additional forms of incentives

Location: Tallahassee, FL (onsite)
Salary: USD 56,200 - 101,000 per yearly
Minimum experience: 2 years