This is a fully remote position, however, you must be located within 2 hours of San Diego, CA.

Position Overview :

You will assist with case resolution and member issues. Advise and recommend areas of program planning, business requirements management, budget execution and program coordination. Prepare needs assessments. Validate resource requirements and develops cost estimate models. Conduct and coordinate financial, product, market, operational, and related research to support strategic and business planning within the various departments and programs of the client group. Interpret, evaluate, and interrelate research data, and develop integrated business analyses and projections for incorporation into strategic decision-making. Plan and coordinate the development of primary and secondary market research studies in support of strategic planning and specific marketing initiatives, as required, and present findings of studies to client committees. Provide consultative, advisory, technical, and staff support, as appropriate. Ability to use survey and market research methodologies, systems, and techniques is a strong plus.

Top Daily Responsibilities:

• Focuses on case resolution with emphasis of coverage issues to ensure no discrepancies exist among systems, with our members complaints.
• Supports daily Business Case Development through timely analysis and resolution of member complaints by performing research and review through multiple systems.
• Perform / timely follow up through member cases.
• Ability to communicate with members when required.

Top Required Skills Candidate Should Have:

• Analytical skills - a must, in order to perform accurately and timely on cases, to ensure a first time full resolution is achieved.
• Research and analysis background ideally doing some kind of case management or resolution – can come from any industry, healthcare ideally
• Must be able to proactively work in a collaborative Team Environment, demonstrating development of positive relationships with peers.
• Great communication skills to timely provide feedback on issues that might affect multiple members.
• Flexibility to adapt to and to follow ongoing process changes.

• Additional Skills Preferred
• At least 3 years working experience.
• Specific Systems Knowledge Required: Microsoft Office Suite, Intermediate Excel.
• Attention to Detail.
• Case management experience is nice to have.