Healthcare Operations Jobs description
Healthcare operations can be defined as certain administrative, financial, legal, and quality improvement activities of a covered entity that are necessary to run its business and to support the core functions of treatment and payment. A healthcare operations professional is responsible for case management and care coordination of the individual with the healthcare policy. A healthcare operations professional evaluates the health plan performance and contacts healthcare providers or patients with information about treatments. Responsibilities include underwriting, premium rating, and other activities related to the creation, renewal, replacement of a contract of health insurance or health benefits. A healthcare operations professional needs to develop and improve methods of payment and coverage policies.A healthcare operations professional needs to resolve internal grievances within the company with employees or patients in case there exist any. A healthcare operations professional is responsible for determining the terms needed for coverage of health plan and selling, transferring, merging, or consolidating any part of, or the entire health plan.
A healthcare operations professional should be a graduate with prior experience in a related domain.
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