Sr IRIS Ops Specialist - TMG (Must reside in Wisconsin) (Fully remote) (No Weekends, No Holidays, No After Hours) - Military Veterans
at Molina Healthcare
Job Description
Job Summary
The Sr IRIS Operations Specialist is responsible for leading and executing activities and initiatives to support IRIS program operations and field staff in the areas of referrals, enrollments, disenrollments, workload assignments, ongoing eligibility, service authorization, and other requirements of Wisconsins IRIS program. The position requires independent problem solving; strategic thinking and initiative; and the ability to use data to monitor contract compliance, coordination across functions, and technical competencies.
Knowledge/Skills/Abilities
- Provides skilled supports to Operations and field staff in completing data entry and tracking within WISITS, SharePoint, and Power BI.
- Responds to incoming email requests from coworkers, providers, and partner agencies.
- Manages phone queues and assists with outgoing and incoming calls.
- Analyzes data and workflow, offers suggestions for improvement and/or changes to management, and assists with the implementation of changes.
- Maintains primary responsibility, as assigned, for functions such as caseload assignments, financial eligibility support, program eligibility support, enrollment and disenrollment activities, timely welcome calls, prior authorizations, individualized service plan activities, and consultation, training, and support to field staff.
- Manages projects and engages in problem solving and overall process development and implementation within identified areas of primary responsibility and subject matter expertise.
- Ensures assigned areas of primary responsibility operate at high levels of efficiency and in accordance with IRIS program requirements.
- Serves as a liaison to other IRIS partners or providers as needed.
- Establishes and maintains positive and effective work relationships with coworkers, clients, members, providers, and customers.
- Completes other duties as assigned.
- Strong customer service skills
- Excellent written and verbal communication skills
- Excellent organizational, prioritization, and time management skills
- Strong analytical and problem-solving skills
- Ability to adhere to HIPAA rules and maintain strictest confidentiality
- Ability to focus on multiple priorities simultaneously
- Ability to be resourceful, proactive, and detail-oriented, and learn and incorporate new tasks quickly
- Ability to work both collaboratively and independently
- Ability to analyze data, draw appropriate conclusions and recommend solutions
- Ability to seek out opportunities to learn and growembrace challenges and learn from them
- Flexibility in the work environment and willingness and ability to adapt to changing organizational needs
- Demonstrated computer and software skills required; proficiency with Microsoft Office Suite and other software; database operation/maintenance skills and data entry experience
Job Qualifications
Required Education:
- Bachelors degree in a related field or commensurate experience
Required Experience:
- Two or more years of previous applicable experience
Required Licensure or Certification:
Must possess a valid drivers license, maintain adequate auto insurance for job-related travel, and ability to travel within Wisconsin and other states as necessary
PHYSICAL DEMANDS:
Working environment is generally favorable and lighting andtemperature are adequate.Work isgenerallyperformed in anofficeenvironment inwhichthere isonlyminimalexposure to unpleasant and/or hazardousworking conditions.Musthave the abilityto sit for longperiods. Reasonable accommodationsmay bemade toenable individuals with disabilitiestoperformtheessential function.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
#PJCorp
Pay Range: $18.04 - $35.17 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
WI
Molina believes every person, family and community deserves access to high-quality health care regardless of their situation. Our mission is to deliver effective, reliable and affordable health care to those who need it most. We strive to meet the physical, social and emotional needs of each member and to strengthen the communities we serve.
We do this by offering a holistic, community-based approach designed specifically to meet the individual needs of our members.
What started in 1980 as one clinic in Long Beach, aimed at addressing the disparities in access to quality health care, has grown into 19 health plans across the country. For over 40-years we’ve been improving the lives of our 5.1 million members across the country by pioneering health care services exclusively for those with government-sponsored health care.
As our membership has grown over the years, so has our commitment to the communities we serve. In 2020, we launched the MolinaCares Accord, which makes substantial investments to improve members’ access to health care.