Health Plan Operations Specialist

A company is looking for a Health Plan Operations Specialist to support core operational functions within their Health Plan Operations team. Key Responsibilities Analyze claims, provider, and member benefit data to identify discrepancies and issues Research and resolve service issues and escalations from various stakeholders Monitor key performance indicators and deliver actionable insights for operational improvements Required Qualifications At least 2 years' experience in health plan operations or equivalent education and training A bachelor's degree or equivalent education, training, or experience Experience working cross-functionally and managing external vendor relationships Proficiency in Microsoft Excel; experience with data analysis and visualization tools is preferred Ability to work remotely in Texas with quarterly travel to corporate headquarters

Jun 17, 2025 - 18:20

A company is looking for a Health Plan Operations Specialist to support core operational functions within their Health Plan Operations team. Key Responsibilities Analyze claims, provider, and member benefit data to identify discrepancies and issues Research and resolve service issues and escalations from various stakeholders Monitor key performance indicators and deliver actionable insights for operational improvements Required Qualifications At least 2 years' experience in health plan operations or equivalent education and training A bachelor's degree or equivalent education, training, or experience Experience working cross-functionally and managing external vendor relationships Proficiency in Microsoft Excel; experience with data analysis and visualization tools is preferred Ability to work remotely in Texas with quarterly travel to corporate headquarters