Health/Medical Plans Claims Audits and Analytics Consultant
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Our Consultant, Health/Medical Benefits Claims Audits and Analytics has responsibility for leading health/medical benefits claims audits and analyses for our clients.
Key Responsibilities
Perform as the lead health/medical claims audit consultant and/or CRM to clients.
Provide strategic and business-oriented consulting advice on claims auditing practices and results, serving as counsel to clients and internal staff.
Conduct planning meetings to identify/define client needs/issues and develop project plans and approaches that are responsive to client needs.
Conduct technical analyses and quality reviews. Formulate conclusions and deliver client recommendations.
Build and maintain effective rapport internally and with senior management in client organizations, vendors, and internally within the Company.
Manage projects within scope, profitability and productivity targets.
Lead business growth strategies and marketing initiatives to assist business development and cross-selling efforts.
Respond to Requests For Proposals (RFPs) including preparing written proposals, providing pricing information, and defining project scope recommendations.
Gather, use and share market intelligence to develop and introduce unique and/or new approaches to servicing clients.