Business Program Coordinator

is not intended to be all-inclusive; employees will perform other reasonably related business duties as assigned by the immediate supervisor and/or health plan administration, as required.

General Duties

• Maintains utmost level of confidentiality at all times.
• Adheres to Health System and Health Plan policies and procedures.
• Demonstrates business practices and personal actions that are ethical and adhere to corporate compliance and integrity guidelines.
• Performs all other tasks as assigned by upper management.
• Performs other duties as assigned by Director of Member Services and Outreach.

Eligibility Responsibilities

• Coordinates all Eligibility functional, technical and operational activities of the Department.
• Ensures all eligibility related CRMs are worked by the team within the appropriate timelines.
• Answers eligibility related questions from other departments.
• Liaison between the Enrollment Broker, HHSC, Dental and Pharmacy vendors on all eligibility and enrollment matters.
• Ensures staff compliance with HHSC contractual requirements and URAC standards.
• Collaborates with Management to increase eligibility and enrollment metrics, by identifying trends, communicating changes, and driving the feedback process.
• Analyzes reports, understand trends, forecast changes and develop action plans in response.
• Assists Tapestry team and Data Integrity to ensure eligibility files are generated and loaded in a timely manner.

Value Added Services Responsibilities

• Assists with the execution, accountability and budgetary requirements of the Value-Added Services Program which includes conducting research and analysis of current and future Value-Added Services when required.
• Ensures all VAS related CRMs are worked by the team within the appropriate timelines.
• Answers VAS related questions from other departments
• Assists with oversight of the VAS program
• Assists with obtaining and negotiating VAS contracts
• Assists with analyzing ROI and utilization data to determine viability of each benefit
• Assists with development of HHSC templates and comparison charts for each LOB
• Assists with researching new VAS benefit opportunities including projecting potential ROI

Education and/or Experience

• Prefer Bachelor's degree (B. A.) from four-year College or university and minimum of 2-3 years related experience and/or training; or equivalent combination of education and experience.
• Minimum two years in data analytics or reporting
• Prefer one year of Managed Care Experience
• Prefer two years in SQL/database experience
• Strong knowledge of Microsoft Office, including Word, Excel, PowerPoint and Outlook.