Operations Client Relationship Issue Resolution Analyst - Dale Workforce Solutions

Client: Healthcare
Hybrid: 3x per week 
Location: Philadelphia, PA 
FTE/Contract: Contract to Hire

This role plays a critical role in managing and resolving complex operational issues for our high priority clients. They collaborate closely with cross-functional business areas across sales and account management, claims, billing, enrollment, implementation, reporting, and other internal teams to address retrospective issues, improve operational efficiency, proactively reduce future issues, and ensure timely resolution of client challenges. Our priority is to provide exemplary services to all our clients.

Responsibilities

• Manage client-specific issues and requests to completion in an efficient and timely resolution. Identify the root cause of issues, document holistic solutions, and ensure solutions are implemented to prevent recurrence.
• Collaborate with cross-functional team members as appropriate to quickly resolve issues that require engagement from various subject matter experts.
• Executive Communications: Cultivate relationships with Independence Sales and Account leadership and client leadership by strategically summarizing issue details, root cause analysis, remediation pathway, and the potential impact to the member, provider, or client experience. Present findings, plan of action, and result to internal and client leadership teams.
• Support the updating of issues in existing issue databases to enable thoughtful reporting on issue management key performance indicators, and ensure clients are kept privy to issue management activities.
• Identify opportunities for process improvements and recommend solutions to enhance operational efficiency.

Qualifications:

• Bachelor's degree in healthcare administration, business or a related field preferred or extensive experience in issue management, operations, or health insurance.
• 3+ years of experience in relevant healthcare operations and project management, with self-funded claims experience preferred.
• Familiarity with healthcare payer operations and self-funded group management.

Skills:

• Strong analytical skills to identify trends and resolve complex operational issues, ability to "tell a story,” and provide recommendations.
• Excellent communication skills to effectively translate complex issues to leadership stakeholders.
• Proficiency in Microsoft product suite (e.g., Outlook, Teams, Excel, PowerPoint)
• Project management and ability to bring subject matter experts together and keep deliverables on track.
• Has working knowledge of the organization, processes, and customers
• Works independently; receives minimal guidance.
• Demonstrated self-starter with strong problem-solving, attention to detail, analytical, organizational, and writing skills.
• Solves complex problems; takes a new perspective on existing solutions.

.