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LOCATION: 3031 N. Rocky Point West, Tampa, FL 33607
DEPARTMENT: FL - Operations
REPORTING TO: Director, Operations Account Manager
Manages the relationship and all levels of operations support with network hospitals. Provides ongoing education to facilities regarding health plan operations. Identifies and implements process improvements and enhancements.
Establishes and maintains strong business relationships with hospitals in assigned area.
Responds in a timely fashion to identified concerns.
Plans and facilitates hospital meetings as needed.
Designs and implements programs to build and nurture positive relationships between the health plan, providers (hospitals/facilities) and hospital administrators.
Performs provider education through in-service activities and regularly scheduled follow up with providers.
Effectively influences outcomes of key internal and external business issues.
Identifies internal and external operational short-falls and researches and remediates claims.
Executes internal business initiatives (e.g. EDI, EFT/ERA).
Researches, collects and analyzes data on hospitals and other assigned projects.
Designs reports to serve as a basis for decision making on hospital related issues.