Provide Key Accounts new business sales support for the Account Executives handling cases in the 100 5,000 segment for Medical and Specialty (ancillary) products Will also provide support for the Strategic Account Executives managing existing Key Accounts cases in offering new coverages (i.e., renewal upselling) Coordinate and execute the new business presale process to a

Customer retention, based on established annual goals Strategic planning for multi year initiatives to identify opportunities to better manage healthcare trends Responsible for communicating and managing escalated issues and problem resolution as appropriate Maintains appropriate documentation including action plans, meeting notes, Strategic Customer Business Plans, Sales

Mainly handling inbound calling, NO knocking on doors Answer incoming phone calls from prospective members and identify the type of assistance and information the customer needs with the goal to convert the caller to a qualified lead and ultimately sale Ask appropriate questions and listen actively to identify specific questions or issues while documenting required inform

Work collaboratively with the interdisciplinary care team, specifically external entities such as OhioRise, Care Management Entities, and Provider Practices; to ensure an integrated team approach Engage members either face to face or over the phone to assist with closing gaps in care, linking to necessary services and providing education about their health Review availabl

Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, at least restrictive level of care Identify and initiate referrals for social service programs; including financial, psychosocial, community and state supportive services Manage the care plan throughout the continuum of care as a single point of contact

Relationship Building Uses our CRM tool to create a proactive engagement plan and monitor engagements for assigned groups Develop and maintain solid customer and broker relationships, in person and telephonically Partner with the local team and other Field Based Staff Develop and maintain key internal relationships Understand customer needs, where to prioritize efforts, a

Engage members face to face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs Develop and implement person centered care plans to address needs including management of chronic health conditions, health promotion and wellness, social determinants of health, medicati

Perform audit and risk surveillance activities in accordance with IIA audit standards and the Internal Audit & Advisory Services Charter Executes Internal Audit's segment specific strategies and framework for data enabled Key Risk Indicators (KRI) and Continuous Auditing (CA) by determining and documenting relevant management metrics and mitigating controls for top risk a

Consult with users and technology specialists to define business processes and be the liaison between the two parties Perform Business Analysis Ability to define project objective, scope, write business and technical requirements Business Liaison to refine business requirements Communicate and validate requirements with stakeholders Validate solution meets business needs

Identify potential health care business customers Develop business relationships with agents and/or brokers to increase sales Promote sales of health care and ancillary products to Mid Market Employers through brokers. This includes educating and keeping brokers up to date on products and pricing, evaluating, and discussing with brokers, developing recommendations on whic

Acts as primary CAHPS Manager Collaborating with leadership, develop and drive tactical plan that can be leveraged across the enterprise to achieve CAHPS goals Manages vendor relationships to support CAHPS program Analyzes key KPI's and data to derive progress and opportunities for improvement Establishes and reviews performance metrics on a regular basis to ensure effort

Serve as primary care manager for high medical risks / needs members with comorbid behavioral health needs Engage members face to face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic (SDoH) needs Develop and implement individualized, person centered care plans inclusiv

Telecommute Healthcare Advocate

Telecommute CDI Specialist (St. Louis, MO)

Supports complex employer groups with 1000+ subscribers, generally within specific geographic areas Extensive analysis and interpretation of complex healthplan performance analytics from multiple data sources Synthesize complex datasets to understand risk and opportunity of proposed/implemented solutions in support of both short and long term customer strategic needs Quan