About Texas Children's Hospital
Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.
To join our community of 14,000+ dedicated team members, visit texaschildrenspeople.org
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Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
We are searching for a Health Plan Business Operations Training Coordinator -- someone who works well in a fast-paced setting. In this position, you will lead in the design, development, and implementation of training programs for new and existing employees to enhance the competency, performance, and professional development of Business Operations team. This position is critical in the development and ongoing accuracy of system configuration, including Benefits, Contracts, Pricing, and Claims editing, member enrollment and eligibility, Provider configuration and maintenance, and a robust understanding of Claims payments, and processes.
Think you’ve got what it takes?
- Designs and Develops Training manual and Standard Operating Procedures to encompass all areas of Business Ops
- Conducts training program to provide an effective and interactive learning environment to achieve departmental goals and objectives utilizing innovative, professional communication methods
- Completes audits, consistent with industry standards, of each trainees’ s completed learnings throughout the training course and within the nesting period
- Performs specific training on Information Systems used in Business Operations Configurations
- Recommends configuration enhancements to improve new and preexisting configuration
- Applies knowledge and understanding of the EDI 834 Enrollment file to create effective training materials and providing input on department operations as requested
- Assures that the team is understanding of the reconciliation process, and work closely with the Manager and the Sr. Business Process Specialty to identify any additional required changes
- Proficient understanding for the Master Provider File allowing for the transfer of knowledge to other team members through the creation of educational and training materials
- Bachelor’s degree required
- 3 years managed care, claims processing, and/or configuration of benefits/contracts/fee schedules/medical policy payment rules required
- Previous training experience in an adult training environment preferred
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