Business Solutions Specialist jobs in the United States

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Customer Solutions Center Appeals and Grievances (A&G) Training Specialist II
  • CCG Business Solutions, LLC
  • Los Angeles, CA FULL_TIME
  • Company Description

    CCG Talent Management is not only a business solutions company but a company that believes success starts with the individual. CCG Business Solutions has been consulting and providing talent placement services since 2007. Our team understands the principles of connecting purpose to business. We are currently recruiting for an Customer Solutions Center Appeals and Grievances (A&G) Training Specialist II . 

    Job Description

    The Customer Solutions Center Appeals and Grievance (A&G) Training Specialist II is responsible for providing ongoing training on the core processing system, A&G processing procedures, training regulatory changes which will affect established procedures, working with the quality team on quality and performance guidelines, creating and maintaining departmental policy and procedures. Additional responsibilities include evaluating initial training and ongoing learning opportunities to achieve consistency, efficiency, and productivity among the staff.

    They will also apply knowledge and skills to build competencies for the design of training programs that will boost employee’s workplace performance in alliance with Enterprise and departmental goals. Responsible for performing training needs assessments with the department management and will leads the design and delivery of  curriculum and learning materials to ensure the success of new and current staff.

    Conducting training for Customer Solution Center A&G team in customer service, product operations, and other work processes. Conducts training sessions covering specified areas such as on-the-job training, use of computers and software, interpersonal skills, quality & process issues, and product knowledge.

    Maintain documentation, including database/system updates, training agendas, sign-in sheets, etc. to demonstrate trainee compliance with department requirements.

    Work with key stakeholders to monitor error trends, productivity, and quality standards for the program. Identifies gaps in knowledge, skills and abilities, assess and recommend training/education measures to resolve issues and enhance staff performance.

    Propose program modifications to enhance performance and positively influence member satisfaction survey results.

    Conduct assessments after training to measure, record, and report feedback on training material and sessions. Serve as coach staff to handle problems and concerns as they arise.

    Review and recommends updates on policy and procedure critical to claims process.

    Required:
    Strong understanding of learning principles and ability to demonstrate in classroom (or virtual classroom) situations.

    Knowledge of CA regulatory guidelines, Medi-Cal guidelines, Medicare guidelines, NCQA requirements.

    Skilled in group facilitation and managing effective discussion and dialogue to enhance the learning experience.

    Strong organizational & analytical skills.

    Ability to conduct effective and engaging presentations in a variety of delivery settings.

    Ability to interpret technical data, processes, operating and maintenance instructions and procedure manuals.

    Must be a strong team player willing to work toward achieving team goals. Must be flexible to meet the changing training needs.

    Professional demeanor. Commitment to Team Culture.

    Excellent written and verbal communications skills.

    Proficient using Word, Excel, Power Point and Access. 

    Qualifications

    A minimum of 3-5 years of Managed Care, Medicaid, Medicare experience is required.

    A minimum of 3-5 experience in design and delivery (facilitating and coordinating) of training programs.

    Bachelor's Degree in Business Administration or Healthcare Related Field

    In lieu of degree, equivalent education and/or experience may be considered.

    Additional Information

    Salary: $77,265 - $100,445 per year

     

  • 4 Days Ago

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Document & Business Solutions Specialist
  • JPMorgan Chase
  • Plano, TX FULL_TIME
  • Document & Business Solutions (DBS) is the company’s primary mail and print production provider for the firm, globally, operating across APAC, EMEA, LATAM, and NAMR in more than 50 cities. DBS is resp...
  • 25 Days Ago

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Senior Specialist, Business Solutions
  • EXTERNAL
  • Alexandria, VA FULL_TIME
  • The Senior Specialist, Business Solutions manages various premium product partnerships and is a key contributor to the identification, vetting, development, implementation, sales, delivery, and strate...
  • 2 Days Ago

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Business Solutions Specialist
  • Health Action Council
  • Independence, OH FULL_TIME
  • POSITION TITLE: Business Solutions Specialist REPORTS TO: Marketing and Communications Leader SALARY GRADE: Salary We are currently searching for a savvy, energetic, and dedicated Business Solutions S...
  • 15 Days Ago

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Business Solutions Specialist
  • Assemblies Of God Credit Union
  • Springfield, MO FULL_TIME
  • AGCU is a not-for-profit Credit Union serving the Assemblies of God community locally, regionally, nationally and worldwide. We offer a comprehensive range of personal, business, commercial and church...
  • 16 Days Ago

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ETL Specialist
  • Central Business Solutions, Inc
  • Seattle, WA FULL_TIME
  • Position Role/Tile: ETL Specialist Location: Seattle, WA​​. Client is looking for a ETL Specialist having expertise in Informatica. Strong Database exp (SQL Server) and Linux. Central Business Solutio...
  • 25 Days Ago

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Section 508 Specialist
  • TestPros
  • Sterling, VA
  • Company Overview TestPros is a successful and growing business, established in 1988 to provide Information Technology (I...
  • 5/28/2024 12:00:00 AM

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Healthcare Transition Project Planner
  • Gilbane Building Company
  • Leesburg, VA
  • Overview The Transition Planner implements and executes project activities on a transition project at the direction of m...
  • 5/28/2024 12:00:00 AM

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Analyst, Technical Solutions
  • Visa
  • Ashburn, VA
  • Company Description Visa is a world leader in payments and technology, with over 259 billion payments transactions flowi...
  • 5/28/2024 12:00:00 AM

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Title Research Specialist - CC
  • Pike Corporation
  • Sterling, VA
  • SUMMARY: The Title Research Specialist works in the easement procurement process related to distribution or transmission...
  • 5/26/2024 12:00:00 AM

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Human Resources Business Partner
  • TekStream Solutions
  • Tysons Corner, VA
  • If you are a dynamic HRBP with the ability to think strategically, we'd love to chat with you! We are seeking a positive...
  • 5/25/2024 12:00:00 AM

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RF Engineer/Specialist
  • BAE Systems
  • Sterling, VA
  • **Job Description** BAE is looking for highly motivated people with experience in wireless and RF technologies to includ...
  • 5/25/2024 12:00:00 AM

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Technical Business Consultant -UX/UI
  • Serco North America
  • Herndon, VA
  • Position Description : We're looking for application developers to join our Facilities & Asset Management Solutions cons...
  • 5/24/2024 12:00:00 AM

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Russian OSINT Specialist
  • Leidos
  • Reston, VA
  • Description We at Leidos are seeking you, our next Russian OSINT Specialist to provide collection and exploitation of pu...
  • 4/30/2024 12:00:00 AM

Income Estimation for Business Solutions Specialist jobs
$43,041 to $59,617