Skygen Remote Jobs | Without Experience & Degree (Work From Home)

By | July 23, 2022

Job Responsibilities : Benefit Management Analyst I

Salary : $64700 per year

Company : SKYGEN USA

Location : Remote US

Educational requirements : Associate Degree

Job Purpose: The Benefit Management Analyst I supports the analysis and monitoring of provider behavior to promote appropriate care to members while controlling costs for our clients measuring provider data and maintains appropriate documentation for tracking activity and results for the department. Collaborates with other areas including client experience team clinical provider relations and developers.
Essential Job Responsibilities:
This list of duties and responsibilities is not intended to be a complete list of all the duties and responsibilities performed by incumbents. Duties responsibilities and expectations may be added deleted or modified at any time at the discretion of the supervisor.
  • Maintain all internal information in an organized manner document and track results of all departmental activity.
  • Analyze provider data to identify outlier provider performance. Provide in-depth analysis of data/provider payments to determine potential outliers or data trends. Assist with identifying root cause issue and communicate findings to appropriate staff.
  • Ensure all cases are properly documented for reference and review.
  • Develop and recommend action plans for enhancing benefit outcomes to members while controlling costs.
  • Develop and maintain processes and all relevant documentation used to take corrective actions with providers.
  • Follow company guidelines for changing provider behavior and/or removing outlier providers when abnormal behavior is identified.
  • Create and regularly review standard benchmarks for each market regarding network performance.
  • Coordinate targeted provider’s random chart audits to ensure standards are met and appropriate peer committee reviews.
  • Utilize internal systems to generate information and analyze using system reports.
Additional Responsibilities:
  • Complete various ad-hoc report requests as able.
  • Contribute to the team effort by accomplishing additional responsibilities as needed.
Minimum Qualifications:
To perform this job successfully an individual must be able to perform each essential duty
satisfactorily.
The requirements listed below are representative of the knowledge skill and/or ability required. Reasonable accomodations may be made to enable individuals with disabilities to perform the essential functions.
  • Required Level of Education Licenses and/or Certificates
    • Associates Degree/Two Year Degree in math/stats/finance/accounting or a related field of study is required.
  • Required Level of Experience
    • 1-3 years of job related experience
  • Required Knowledge Skills and Abilities
    • Intermediate knowledge of Excel Word and PowerPoint.
    • Intermediate knowledge of email.
    • Able to remain organized with multiple interruptions.
    • High attention to detail.
    • Analytical skills that assist in ability to solve routine problems.
    • Excellent time management skills.
    • Good oral communication skills.
    • Ability to work well with a variety of individuals.
    • Ability to work well independently.
  • Competencies
    • Analytical Thinking – The ability to tackle a problem by using a logical systematic sequential approach.
    • Initiative – Identifying what needs to be done and doing it before being asked or before the situation requires it.
    • Detail Oriented – Ensuring that one’s own and/or others’ work and information are complete and accurate; carefully preparing for meetings and presentations; following up with others to ensure that agreements and commitments have been fulfilled.
    • Disseminating Information – The ability to ensure that information is passed on to others who should be kept informed.
    • Building Collaborative Relationships – The ability to develop maintain and strengthen partnerships with others inside or outside the organization who can provide information assistance and support.
    • Diagnostic Information Gathering – The ability to identify the information needed to clarify a situation seek that information from appropriate sources and use skillful questioning to draw out the information when others are reluctant to disclose it.
Preferred Qualifications
  • Bachelor’s degree in math/stats/finance/accounting or a related field of study is preferred.
Equipment Used:
  • Phone
  • PC/Keyboard
  • Copier/Scanner/Fax
Physical Demands and Work Conditions
The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
  • Physical Demands
    • Use a PC computer terminal and/or telephone over 8 hours a day
    • Ability to sit more than 75% during an 5 hour workday
    • Ability to communicate in an active office environment
    • Ability to operate all required job related equipment
    • Occasional long irregular hours
    • Occasional standing and moving throughout the facility.
  • Work Conditions
    • This position is located in a wheelchair accessible building. The office environment is active with high voice levels frequent interruptions which may challenge hearing and concentration. The statements in the above sections of this description are not all inclusive and job duties and responsibilities may change due to business necessity.

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