Health Operations Associate

About the Role

• Embedding digital transformation in healthcare operations end-to-end, driving superior outcomes and value realization, and enabling streamlined operations to serve the emerging healthcare market.

Key Responsibilities

• HM- Utilization Management: Evaluating the necessity, appropriateness, and efficiency of healthcare services to ensure patients receive the right care while managing costs effectively.
• Reviewing medical records.
• Coordinating with healthcare providers.
• Making coverage decisions.
• Optimizing resource use and improving patient outcomes.
• Managing day-to-day operations, department activities, medical and health services, budgeting and rating, research and education, policies and procedures, quality assurance, patient services, and public relations within healthcare facilities.
• Solving routine problems, largely through precedent and referral to general guidelines.
• Interacting within your own team and direct supervisor.
• Receiving detailed to moderate level of instruction on daily work tasks and detailed instruction on new assignments.
• Making decisions that impact your own work.
• Acting as an individual contributor as part of a team with a predetermined, focused scope of work.

Requirements & Tech Stack

• HM- Utilization Management
• Healthcare Management
• Health Insurance Data Requests
• Referrals
• English (Domestic) - Advanced

Qualifications

• Any Graduation
• Ability to perform under pressure
• Adaptable and flexible
• Ability to meet deadlines
• Ability to handle disputes
• Strong analytical skills
• Knowledge of healthcare regulations

Note: This role may require working in rotational shifts.