Health Plan Specialist - HP Network Development

Summary:

Provides entry-level operational, analytical, and administrative support across core health plan functions, including claims processing, member and provider operations, network administration, quality programs, regulatory compliance, and data coordination. Supports routine business processes, helps maintain accurate records, assists with issue resolution, and contributes to the overall efficiency and service quality of the health plan.

Responsibilities:

• Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
• Supports day-to-day activities within assigned health plan department (e.g., claims, enrollment, provider relations, quality, compliance, analytics).
• Assists in processing routine transactions such as member eligibility updates, provider information changes, or claim documentation.
• Collects, organizes, and validates data used for departmental reporting, quality tracking, or regulatory submissions.
• Prepares basic summaries, spreadsheets, and dashboards under guidance from senior team members.
• Responds to internal inquiries from other health plan teams (claims, customer service, provider operations, etc.).
• Assists in researching member or provider questions and prepares information for resolution.
• Follows established workflows, standard operating procedures, and compliance requirements.
• Participates in continuous improvement efforts and identifies opportunities to streamline work.
• Supports departmental projects such as audits, document updates, quality initiatives, or system enhancements.
• Helps track the status of work items, escalating issues according to established procedures.
• Must provide courteous and timely communication to internal and external stakeholders.
• Must have strong attention to detail with the ability to accurately enter and review data.
• Must have the ability to work with structured processes and follow documented procedures.
• Must possess strong communication (written and verbal), organizational, and analytical skills.
• Must have ability to manage multiple tasks and deadlines.
• Must have demonstrated ability to learn new systems, concepts, and workflows quickly.
• Must have strong customer service orientation and professional demeanor.
• Must have eagerness to learn and grow in a collaborative, mission-driven environment.

Job Requirements:

Education/Skills
• Bachelor’s Degree in Business, Public Health, Healthcare Administration, Information Systems, or related field required.

Experience
• Experience working with spreadsheets (Excel), databases, or electronic systems is preferred.
• Proficiency with Microsoft Office applications, especially Excel and Outlook required.
• Proficient in Microsoft Word and PowerPoint.
• Internship experience preferred.

Licenses, Registrations, or Certifications
• NA

Work Schedule:

8AM - 5PM Monday-Friday

Work Type:

Full Time