The Manager of Broker Sales Operations oversees the operational integrity of the broker infrastructure, including onboarding, system configuration, and enrollment tracking. This role acts as a liaison between Sales, Finance, Compliance, and IT to ensure brokers are ready-to-sell and compensation is accurate.
Village Care
5 Remote Job Openings at Village Care
The manager coordinates Risk Adjustment and Quality coding operations, overseeing retrospective and prospective chart reviews and supervising coding staff. They act as the operational bridge between Risk Adjustment and HEDIS teams to improve RAF performance and STARs quality outcomes.
Serves as the clinical lead for the Utilization Management Department, overseeing case reviews, appeals, and medical quality activities. Responsible for analyzing utilization patterns and ensuring compliance with state and federal regulatory requirements.
Develop and maintain financial reports and dashboards using SQL, Tableau, and RedShift to provide leadership with key strategic insights. Support the monthly close process, conduct claim reserve analysis, and manage medical claims reinsurance reporting.
Develop and maintain financial reports and dashboards using SQL, Tableau, and RedShift to provide leadership with key strategic insights. Manage claims reserve analysis, IBNR estimation, and medical claims reinsurance reporting to ensure financial accuracy and regulatory compliance.
