ANALYST EXCHANGE PRODUCTS PCHP
Centra Health, Inc.

Lynchburg, Virginia

Posted in Medical and Nursing


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Job Info


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Partnering with you to live your best life. At Centra, we want to listen carefully and get to know you well. We want to understand your hopes, goals and dreams. We want to do our part so you can be your very best - as you define it. This remains true whether you are a patient, a Centra Caregiver, or a member of the communities we serve. As a candidate considering employment with our organization, we want you to understand that it is our mission to help partner with you throughout each stage of your career.
COVID Vaccination Requirement

Consistent with long-standing practices requiring health care workers to be vaccinated against serious infectious diseases for the safety of patients and staff, Centra will require COVID-19 vaccinations for all new and current employees and those who work in Centra facilities as a condition of their employment. If hired to work at Centra, you will be required to provide proof of vaccination or be willing to receive the vaccination. Medical and religions exemptions may be requested.
Job Description

Overview

Job Description: This individual assists the Director of the Health Benefit Exchange with product development, health plan operations, and finance functions. The position involves thorough analysis of data to ensure consistent delivery of Piedmont's Exchange program, which includes reviewing data from the CMS Marketplace, enrollment/billing, medical/pharmacy claims, customer service, sales/marketing, etc. This individual should be well versed in the healthcare and/or insurance industry and understand requirements to maintain compliance with federal & state regulations.

  • Operational Execution and Administration
    • Assists with maintaining accuracy of enrollment and premium data within the core administration systems.
    • Owns payment reconciliation and dispute processes between CMS and Piedmont. Ensures that necessary corrective action(s) are performed timely and accurately.
  • Product Development Functions
    • Assists the Director with the process of filing prospective year health insurance plans with the state BOI and CMS.
    • Owns responsibility for ensuring plan documents are accurate prior to submission, including regulatory review, and plan preview testing.

Qualifications/Education/Licensure:

Required: Bachelor's Degree in Finance, Business, Healthcare, or equivalent work experience. Master's Degree preferred.
  • Strong analytical skills and the ability to interpret data and identify key trends.
  • Strong communication skills, including in-person, e-mail, and phone.
  • Ability to work effectively in a team environment and independently without constant supervision.
  • Ability to prioritize and handle multiple projects.
  • Proficiency in Microsoft Office (Word, Excel, PowerPoint, SharePoint, and Outlook).
  • Understand and follow applicable state and federal regulations, and Centra/Piedmont policies and procedures.
  • Experience creating mail merge documents with multiple source fields.
  • This position may require extended hours during peak times.

Our care givers at Centra are the most valuable asset we have and it is our mission and commitment to build and sustain a diverse and inclusive environment.

When recruiting and retaining talent at Centra, our hiring needs are based on matching a candidates job qualifications with our job requirements and department needs without regard to race, color, age, religion or belief, national origin, disability status, protected veteran status, gender identity or expression, sexual orientation or any other characteristic protected by the laws or regulations in the locations where we operate. Centra is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind.

Be yourself. Be a partner with Centra.

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