Provider Call Center Business Specialist

Collect, analyze, and utilize data and feedback related to the Provider Call Center to provide audit oversight upon predefined contractual criteria and identify opportunities to improve operations between HMSA and the vendor team. This will include direct communication and participation with the Vendor Management Office (VMO) and Transformation Management Office (TMO). Compile reports about incidents, events, and updates regarding provider HHIN and phone inquiry issues and provide database management for any escalations.

• Gathers, reviews, and analyzes information to identify trends, issues, and potential problems and solutions related to development and implementation, including but not limited to new products or services, contract deliverables, enhancements to add functionality and / or redesigns of systems, both manual and automated, to improve efficiency, financial models of costing and pricing. This includes reviewing and validating new implementations.
• Initiates the development of strategies and tactics based on logical assumptions and facts considering resources, constraints, and HMSA values. Provides critical assessments of information and data about current trends and issues and actively and openly shares with appropriate parties to encourage collaboration for improvement and change. Translates analysis into solutions and / or options for consideration of specific HMSA actions, including business process improvements.
• Conducts ongoing research and analysis to assess changing needs of our industry. Provides quality, objective, and professional analysis. Initiate change and evaluate impact.

Communicate with vendor team and internal stakeholders to quickly and accurately obtain or provide information regarding HHIN inquiry and provider call updates.

Organize, maintain, and keep readily accessible, all references, documents, policies, and procedures to ensure accuracy on the part of the vendor.