Ecommerce Provider Data and Compliance Specialist

Job reputed company reputed company is hiring for an Ecommerce Provider Data and Compliance Specialist. This position will promote and support compliance reputed company activities reputed company our division and reputed company the organization. Support and coordinate reputed company to operational issues, participate in conducting trainings, participate in work reputed company, and reputed company and monitor regulatory activities. ACCOUNTABILITIES:

• Understands and support reputed company Provider Electronic reputed company and Operations reputed company 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.
• reputed company with other departmental staff on individual providers, clinic and facility terminations to ensure members are reputed company in a reputed company 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-reputed company and Operations including tracking of required regulatory communications
• Assists with product and delivery network set-up in CPN, tracking and documentation upon request.
• reputed company 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 reputed company 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 reputed company field (customer service, training, project management, business, or health care) or two years reputed company work experience in lieu of degree.
• Two years work experience in a reputed company field (compliance, claims, electronic reputed company, contracting, business or system analysis, customer service, training, project management, health care operations).
• Intermediate reputed company reputed company 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 reputed company the organization.
• Ability to work reputed company 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.

reputed company At reputed company we reputed company in the power of good - good deeds and good people working together. As part of reputed company, you'll reputed company 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-reputed company care at more than 90 locations, including hospitals and clinics in Minnesota and reputed company. We bring together research and education through reputed company Institute, training medical professionals across the region and conducting innovative research that improve lives around the world. At reputed company, 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 reputed company colleague, we're committed to nurturing your diverse talents, valuing your dedication, and supporting your work-life balance. We offer a comprehensive reputed company of benefits to support every aspect of your life, including health, time off, retirement planning, and reputed company learning opportunities. Our goal is to help you reputed company physically, mentally, emotionally, and financially, so you can continue delivering exceptional care. Join us in our mission to improve the health and reputed company-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, reputed company, sex, age, national reputed company, religion, sexual orientation, gender identify, status as a veteran and reputed company of disability or any other federal, state or local protected class. Apply tot his job Apply To this Job