Lead Research Support Specialist
Our organization is looking for dynamic individuals who love to learn, thrive on innovation, and are open to exploring new ways to achieve our goals. If this describes you, we want to speak with you. You can help us achieve our vision to lead nationally in innovating equitable whole-person health.
The Lead Research Support Specialist evaluates escalated business incidents to ensure that the information provided is complete and provides a clear definition of the issue. Determines the appropriate Assignment Group for incident based on incident protocols. Determines the next steps needed to bring an issue to resolution. This may include research into the applicable source systems to determine the nature of the issue and identify which business areas need to be engaged to resolve the issue. Provides clear and complete updates to the work notes so users clearly understand the progress and status of every incident. Ensure a root cause is identified for each issue, the correction is made, and any required cleanup of data is completed. Analyze and refine data extracts to create reports.
Responsibilities:
- Develops project strategy and supporting plan for cross division and multiple department initiatives. These complex projects have broad impact on the professional provider network and requests for information about the network.
- Responds to business and technical related questions/problems where Provider data and Pricing is a factor.
- Leads the process of defining business requirements, evaluates system solutions and application proposals.
- Identifies Professional Provider’s application needs, document key business rules and oversee the usability of Professional Provider’s applications.
- Develops cost benefit analysis on each project and proposes solution alternatives for any request.
- Anticipates and prepares for system problems not initially evident to the business users requests and proactively develops plans to address these issues.
- Identifies resources needed to execute the initiatives and system requirements and leads more Specialist and Senior Specialist on executing the plan.
- Conducts periodic reviews and quality checks to ensure systems specifications and system audits to determine that provider reimbursement and provider data setup is accurate
Minimum Requirements
- Bachelor Degree in Business Administration or Computer Science or equivalent work experience.
- 6 years of proven work experience in business unit necessary or equivalent external work experience.
- Previous systems project management experience including the use of project management software or business analysis experience.
- Strong understanding of provider operations required.
- Demonstrated knowledge of cross-divisional work processes and systems and the ability to bring these complex projects to a successful conclusion.
- The ability to work autonomously and make decisions with little direction.
- Self-motivated, highly organized, and detail-oriented as well as above-average problem-solving skills.
Hybrid of Choice:
Independence has implemented a “Hybrid” model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the “Hybrid” model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania.
Independence Blue Cross is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.
Diversity, Equity, and Inclusion
At AmeriHealth, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
About Our Company
Serving more than 8 million people nationwide, including 2.5 million in southeastern Pennsylvania, Independence Health Group — together with its subsidiaries — is the leading health insurance organization in the Philadelphia region. Our mission to build healthier lives for you, your family, and your employees shapes our actions and decisions every day.
At AmeriHealth, we see each of our members as an individual, with unique needs and concerns. We’re dedicated to harnessing the very latest ideas and technologies to deliver access to care that meets those needs and surpasses your expectations. For more information about Independence access our website at www.ibx.com. We’re revolutionizing health care, and our focus is on you!
Equal Employment Opportunity
AmeriHealth is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Agency Disclaimer
All resumes submitted directly to an AmeriHealth employee from a vendor via email, the Internet or in any other form without a valid written search agreement in place for this position from the Independence Blue Cross Family of Companies Human Resources Department will be deemed the sole property of AmeriHealth and the Independence Blue Cross Family of Companies. Please note that no fee will be paid in the event the candidate is hired by AmeriHealth or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process.