TriZetto Elements Product Application Support Sr. Associate

TriZetto Elements Healthcare Product Consulting

Oversee daily operations, including scheduling and trainingPoint of contact for clients, including contract negotiationsNew accountsManage company financials, monitor annual budgetDevelop company procedures and processesDevelop company forms and materialsMaintain files and administrative recordsAssist the Investigator with cases (research, data collection)

Lead multiple cross-organizational teams through product design, bid submission, implementation and reviewCoordinate and execute the Medicare Product Lifecycle from concept through implementation, including lead product strategies and service area expansions, CMS bid submission process.Participate in Medicare Program forums, including Advisory, Leadership and SteeringWork with key provider partners to develop coordinated care network products that support the Triple Aim (better quality, better health, and better cost)Market research/analysis, monitor product performance through collaboration with the Analytics teamForecast and set Sales goalsAssist in annual RFP bids for specific groupsCollaborate with internal and external stakeholders

Create, update and maintain all government related marketing and communication materialsDesign, write, edit and format documents for content and ensure accuracy, CMS regulation and company style, and brand requirements are being metComplete redesign of Medicare Member NewsletterMaintain up-to-date knowledge of CMS regulations and HPMS memosDevelopment of annual materials (ANOC, EOC, AEP materials/letters)Assist in coordination and planning of company sponsored community, provider and member eventsCoordinate print projects with external vendors to ensure accuracy and deadlines are metAssist the Medicare Sales TeamCoordinate website updates with ITCommunications lead for specific departments and/or projects (newsletters, manuals, etc.)Develop and implement process improvementsSpecial projects and project coordination

Build the provider network to ensure members have adequate access to health care providersKey contributor to Service Area Expansion annual projectAnalysis of claims data through use of FacetsNegotiate and implement provider contracts with physician groups, ancillary providers, DME providers and ASC facilitiesDevelop and maintain positive relationships with health care providersDevelop and implement contracting strategiesMaintain up-to-date knowledge of best practices and various payment methodologies (DRG, APC, RBRVS, Case Rate, Per Diem, Percent of billed, etc.)Other assigned projects

Liaison between provider and the health planDevelop and maintain positive relationships with health care providersField provider inquiriesProvide on-site training for provider office staff of systems such as Facets and InTouchConduct semi-annual provider workshopsCollaborate with various departments to ensure providers are kept informed of new policies and changes

Healthcare