Workforce Management Analyst 1 - First Coast Service Options Provider Enrollment
- Hiring from
- United States
- Work type
- Remote
- Posted
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Are you interested in joining a team of experienced healthcare experts and have the ability to shape and transform the healthcare delivery system? At our family of companies, everything we do is to help improve the lives of the nearly 12 million Medicare beneficiaries we serve and 700,000 health care providers who care for them. It is our goal to help create a better health experience for all consumers. Join our winning culture and help transform Medicare for the millions of people who rely on its services.
Benefits info:
* Medical, dental, vision, life and supplemental insurance plans effective the first day of the month following date of hire
* Short- and long-term disability benefits
* 401(k) plan with company match and immediate vesting
* Free telehealth benefits
* Free gym memberships
* Employee Incentive Plan
* Employee Assistance Program
* Rewards and Recognition Programs
* Paid Time Off and Paid Sick Leave
Benefits info:
* Medical, dental, vision, life and supplemental insurance plans effective the first day of the month following date of hire
* Short- and long-term disability benefits
* 401(k) plan with company match and immediate vesting
* Free telehealth benefits
* Free gym memberships
* Employee Incentive Plan
* Employee Assistance Program
* Rewards and Recognition Programs
* Paid Time Off and Paid Sick Leave
SUMMARY STATEMENT
The Workforce Management 1 is responsible for forecasting call center/enrollment workload and scheduling staff to meet inventory demands. This includes developing, creating and disseminating inventory reports to management and team members as well as the real time management of Contact Center, Electronic Data Interchange (EDI, Prior Authorization and Provider Enrollment telephone lines and/or the Provider Enrollment Service Center.
ESSENTIAL DUTIES & RESPONSIBILITIES
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This list of essential job functions is not exhaustive and may be supplemented as necessary.
Create and disseminate reports, develop spreadsheets, charts/graphs and document report processes. (55%)
Reports include but are not limited to:
* Pending and month to date processed timeliness.
* Daily activations pending with age and assignment status.
* Weekly inventory reports (beginning pending, receipts, processed volumes and ending inventory) for Center for Medicare and Medicaid Services (CMS). Weekly inventory reports (beginning pending, receipts, processed volumes and ending inventory).
* Bi-weekly inventory reports (pending age and processed timeliness).
* Creates, disseminates to management and monitors individual employee production statistics. Monitoring includes tracking direct vs. indirect hours against planned allocation as well as trending employee schedule adherence. This monitoring will also include development of schedules for all telephone staff.
Data Analysis (20%)
* Identifies anomalies, potential risks and opportunities for improvement relative to workload via analysis of workload reports.
* Identifies anomalies, potential risks and opportunities for improvement relative to workload via analysis of workload reports.
* Develops, proposes and submits potential improvement plans/actions to mitigate issues relative to meeting CMS performance metrics and improving service levels.
* Tracks and ensures completion of elevated issues. Performs analysis on elevated issues in order to identify root cause and ultimately identify improvement opportunities to reduce elevated issues.
Workload Assignment/Reassignment (20%)
* Monitors workload volumes to ensure appropriate activated volumes are assigned and staff has ample workload. Coordinates employee absences with management in order to reassign workload accordingly as well as to provide early identification and notification to management of potential workload issues based on monitoring of volumes and age of workload. * Monitors call traffic and reacts to unfavorable variance in a real time setting; analyzes historical data and forecasts workload trends; develops action plans to address deficiencies.
* Monitors workload volumes to ensure appropriate activated volumes are assigned and staff has ample workload. Coordinates employee absences with management in order to reassign workload accordingly as well as to provide early identification and notification to management of potential workload issues based on monitoring of volumes and age of workload. * Monitors call traffic and reacts to unfavorable variance in a real time setting; analyzes historical data and forecasts workload trends; develops action plans to address deficiencies.
Special Projects/Research (5%)
* This position will be responsible to assist with special projects that involve research and documenting research results as needed. Most special projects will be the result of CMS Change Requests (CRs) or Technical Direction Letters (TDLs), as well as projects assigned by management based on department needs.
* This position will be responsible to assist with special projects that involve research and documenting research results as needed. Most special projects will be the result of CMS Change Requests (CRs) or Technical Direction Letters (TDLs), as well as projects assigned by management based on department needs.
Performs other duties as the supervisor may, from time to time, deem necessary.
REQUIRED QUALIFICATIONS
* High School Diploma or GED
* 2 years related experience including call center or Medicare experience
* Effective, demonstrated analytical, problem solving and decision-making skills
* Demonstrated, written, verbal and interpersonal communication skills with all levels of the organization* Demonstrated time management skills
* Demonstrated high degree of accuracy
* Demonstrated flexibility
* Ability to handle multiple priorities within strict deadlines and timeframes
* Intermediate PC skills (Word, Power Point, Outlook)
* Advanced working knowledge of Excel, as well as creation of charts and graphs
* Self- motivated and willing to learn new things
PREFERRED QUALIFICATIONS
* Bachelor's degree in related field
* Project Management experience
* Working knowledge/experience of Medicare Systems (Fiscal Intermediary Shared System (FISS), Multi Carrier System (MCS), and Service Connect
The Federal Government and the Centers for Medicare & Medicaid Services (CMS) may require applicants to have lived in the United States for a minimum of three (3) years out of the last five (5) years to be employed with the Company. These years of residence do not have to be consecutive.
Background Investigation: If you are selected for this position, you must undergo a pre-employment Background Investigation, Drug Screen, and Identity Proofing documentation must be cleared prior to hire. Most positions are subject to additional Identity Proofing, Fingerprinting and additional Background Investigation screening conducted by the Federal Government to be granted Enterprise User Administration (EUA) system logical access after you begin your employment. Your continued employment is contingent upon the outcome of the complete additional screening criteria required for the position which must find that you meet the applicable government customer's requirements (e.g., suitable for access to CMS information and information systems), as well as any additional investigation which may be required throughout your employment. If you are found not suitable, your employment may be subject to corrective action, up to and including immediate termination of employment.
Identity Documentation: You must have access to a current and unrestricted REAL ID, U.S. Passport, U.S. Passport Card, Foreign Passport, or U.S. Permanent Residency Documents. Note: Employment Authorization Cards (EAD) are not a substitute for Visas or U.S. Permanent Resident Cards.
"We are an Equal Opportunity/Protected Veteran/Disabled Employer."
This opportunity is open to remote work in the following approved states: AL, AR, FL, GA, ID, IN, IO, KS, LA, MS, NE, NC, ND, OH, PA, SC, TN, TX, UT, WV, WI, WY. Specific counties and cities within these states may require further approval. In FL and PA in-office and hybrid work may also be available.
